Exploring staff experience of economic efficiency requirements in health care: A mixed method study

• Published in: The International journal of health planning and management Vol. 34; no. 4; pp. 1439 - 1455
• Main Authors: Korlén, Sara, Amer‐Wåhlin, Isis, Lindgren, Peter, Thiele Schwarz, Ulrica
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.10.2019
• Subjects: Adult; Clinical governance; Cost Savings - economics; Decision Making; economic efficiency; economic governance; Economic resources; Economics; Efficiency; Efficiency, Organizational - economics; Female; Health administration; Health care; health care staff; Health Knowledge, Attitudes, Practice; Humans; hybrid professionalism; Intrinsic motivation; Male; Medicin och hälsovetenskap; Mixed methods research; motivation; Patients; Personnel, Hospital - psychology; Personnel, Hospital - statistics & numerical data; Professional ethics; Rehabilitation; Resource allocation; Resource Allocation - economics; Resource Allocation - methods; Surveys and Questionnaires; Sweden; Sweden; economic governance; health care staff; hybrid professionalism; motivation; economic efficiency
• ISSN: 0749-6753; 1099-1751; 1099-1751
• DOI: 10.1002/hpm.2813

Summary Background Economic resources are limited in health care, and governance strategies are used to push provider organizations to use resources efficiently. Although studies show that hybrid managers are successful in reconciling economic efficiency requirements with professional values to meet patient needs, surprisingly few studies focus on staff. The aim of this study is to explore staff members' experience of economic efficiency requirements. Methods A mixed method design was applied, targeting multi‐professional staff in the Department of Rehabilitation Medicine in a Swedish university hospital. Survey data was collected (n = 93), followed by focus‐group interviews to support the understanding of the quantitative findings. Findings The findings show that health care staff is knowledgeable and intrinsically motivated to consider efficiency requirements, albeit it should not dominate clinical decisions. However, staff experiences little influence over resource allocation and identifies limitations in the system's abilities to meet patient needs. Staff experience incorporates a local unit and a system perspective. Conclusion Staff members are aware of economic efficiency requirements and will behave accordingly if patients are not at risk. However, their engagement seems to rely on how economic efficiency requirements are handled at multiple system levels and their trust in the system to fairly support patient needs.