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How privatization and corporatization affect healthcare employees’ work climate, work attitudes and ill-health: Implications of social status
Stockholm University, Faculty of Social Sciences, Department of Psychology.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Political liberalization and increased public costs have placed new demands on the Swedish public sector. Two ways of meeting these novel requirements have been to corporatize and privatize organizations. With these two organizational changes, however, comes a risk of increased insecurity and higher demands on employees; the ability to handle these changes is likely dependent on their social status within an organization. The general aim of the thesis is to contribute to the understanding of how corporatization and privatization might affect employees’ work climate, work attitudes and ill-health. Special importance is placed on whether outcomes may differ depending on the employees’ social status in the form of hierarchic level and gender. Questionnaire data from Swedish acute care hospitals were used in three empirical studies. Study I showed that physicians at corporatized and privatized hospitals reported more positive experiences of their work climate compared with physicians at a public administration hospital. Study II showed that privatization had more negative ramifications for a middle hierarchic level (i.e., registered nurses) who reported deterioration of work attitudes, while there were no major consequences for employees at high (physicians) or low (assistant nurses) hierarchic levels. Study III found that although the work situation for women and men physicians were somewhat comparable (i.e., the same occupation, the same organization), all of the differences that remained between the genders were to the detriment of women. The results of this thesis suggest that corporatizations and privatizations do not necessarily imply negative consequence for employees. However, the consequences appear to differ between groups with different social status. Employees whose immediate work situation is affected but who do not have sufficient resources to handle the requirements associated with an organizational change may perceive the most negative consequences.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University , 2010. , 70 p.
Keyword [en]
Privatization, corporatization, organizational change, ownership, healthcare employees, acute care hospitals, physicians, social status, hierarchic level, gender, work climate, work attitudes, ill-health
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-37308ISBN: 978-91-7447-019-2 (print)OAI: oai:DiVA.org:su-37308DiVA: diva2:298968
Public defence
2010-04-12, David Magnussonsalen (U31), Frescati Hagväg 8, Stockholm, 10:00 (Swedish)
Opponent
Supervisors
Note
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Manuscript.Available from: 2010-03-21 Created: 2010-02-22 Last updated: 2010-06-15Bibliographically approved
List of papers
1. Physicians’ work climate at three hospitals under different types of ownership
Open this publication in new window or tab >>Physicians’ work climate at three hospitals under different types of ownership
2005 (English)In: Change and Quality in Human Service Work: Organizational psychology and health care, München: Rainer Hampp , 2005, 47-65 p.Chapter in book (Other academic)
Abstract [en]

In an attempt to make hospitals more cost effective and improving the quality of medical care, privatization of Swedish hospitals have become more frequent during the past decade. There is a need for knowledge about psychological effects of privatization on health care personnel. We investigated physicians' perception of their work environment in three hospitals with different forms of ownership - from traditional public administration to for-profit private stock company. The results point towards certain advantages of privatized hospitals. Physicians at the privatized hospital included in the study perceived their work environment in some respects as more positive than did the physicians at the non-privatized hospitals.

Place, publisher, year, edition, pages
München: Rainer Hampp, 2005
Keyword
work climate, health care, privatization
National Category
Psychology
Identifiers
urn:nbn:se:su:diva-13570 (URN)3-87988-915-5 (ISBN)
Available from: 2008-04-11 Created: 2008-04-11 Last updated: 2010-02-22Bibliographically approved
2. How are employees at different levels affected by privatization?: A longitudinal study of two Swedish hospitals
Open this publication in new window or tab >>How are employees at different levels affected by privatization?: A longitudinal study of two Swedish hospitals
2009 (English)In: Journal of Occupational and Organizational Psychology, ISSN 0963-1798, E-ISSN 2044-8325, Vol. 82, no 1, 45-65 p.Article in journal (Refereed) Published
Abstract [en]

Despite the amount of privatizations around the world in recent decades, only limited research attention has been paid to how privatization affects the employees. The effects are likely to vary depending on the individual’s position in the organization. The aim of this study was to investigate how employees’ work-related attitudes and strain changed after privatization of a Swedish acute care hospital, and to analyze whether the effects of privatization differed between employees at various hierarchic levels. Questionnaire data collected at a hospital 1 year before and 2 years after privatization, as well as at a hospital which remained a public administration unit, suggest only limited effects of privatization on a general level, but that employees at various hierarchic levels may be affected differently. While employees at a high level (physicians) and low level (assistant nurses) reported only marginal differences over time in work attitudes and strain, also in comparison with their colleagues at the comparison hospital, work attitudes of employees at the intermediate level (registered nurses) decreased after privatization. These results emphasize the importance of taking hierarchic level into account when a privatization is implemented and analyzed.

Keyword
privatization, hierarchic level, hospital
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-27606 (URN)000262634300003 ()
Available from: 2009-05-08 Created: 2009-05-08 Last updated: 2017-12-13Bibliographically approved
3. Gender differences in physicians’ psychological climate, work-related attitudes and health
Open this publication in new window or tab >>Gender differences in physicians’ psychological climate, work-related attitudes and health
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The gender segregated labor market makes it difficult to investigate gender differences without confounding gender with such as sector, occupation or position. The present study aims to 1) investigate if psychological climate can be measured in the same way for women and men working in the same occupation, 2) compare whether levels of psychological climate as well as work-related attitudes and ill-health differ between the genders, and 3) investigate how psychological climate relates to work-related attitudes and ill-health for women and men. Questionnaire data were collected at one occasion from women (95) and men (105), working as physicians at one acute care hospital in Stockholm, Sweden. When taking gender differences in the appraisal of psychological climate into account (along with background variables), all differences found (in workgroup climate, organizational commitment, mental- and physical health complaints) were to the disadvantage of women. Role stress appeared as an important factor for negative work-related attitudes and ill-health among both women and men, while workgroup was related to better well-being and organizational characteristics to more positive attitudes only among men. More research is needed to study the often taken for granted similarities of genders’ appraisal of psychological climate. Gender should definitely be taken into account when psychological climate, work-related attitudes and ill-health are investigated. Organizations need to intensify their work with status aspects in relation to gender.

Keyword
Gender, psychological climate, work-related attitudes, ill-health, physicians
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-37261 (URN)
Available from: 2010-02-19 Created: 2010-02-19 Last updated: 2010-02-22

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