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      Physicians' working conditions and job satisfaction: does hospital ownership in Germany make a difference?

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          Abstract

          Background

          A growing number of German hospitals have been privatized with the intention of increasing cost effectiveness and improving the quality of health care. Numerous studies investigated what possible qualitative and economic consequences these changes issues might have on patient care.

          However, little is known about how this privatization trend relates to physicians' working conditions and job satisfaction. It was anticipated that different working conditions would be associated with different types of hospital ownership. To that end, this study's purpose is to compare how physicians, working for both public and privatized hospitals, rate their respective psychosocial working conditions and job satisfaction.

          Methods

          The study was designed as a cross-sectional comparison using questionnaire data from 203 physicians working at German hospitals of different ownership types (private for-profit, public and private nonprofit).

          Results

          The present study shows that several aspects of physicians' perceived working conditions differ significantly depending on hospital ownership. However, results also indicated that physicians' job satisfaction does not vary between different types of hospital ownership. Finally, it was demonstrated that job demands and resources are associated with job satisfaction, while type of ownership is not.

          Conclusion

          This study represents one of a few studies that investigate the effect of hospital ownership on physicians work situation and demonstrated that the type of ownership is a potential factor accounting for differences in working conditions. The findings provide an informative basis to find solutions improving physicians' work at German hospitals.

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          Most cited references44

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          Measuring psychological stress and strain at work - Evaluation of the COPSOQ Questionnaire in Germany

          The undisputed increase of the relevance of mental work load is confronted with a lack of qualified or at least well documented measuring instruments covering all important aspects. The COPSOQ (Copenhagen Psychosocial Questionnaire), a comprehensive instrument for the assessment of psychosocial factors at work, was tested in a partly modified version in a large German sample (N = 2561 employees). The aims of the study were the detailed investigation of the psychometric measurement properties, and based on these results, the development of an abbreviated version of the instrument. The analysis of objectivity, acceptance, practicability, sensitivity and content validity of the questionnaire as a whole did not show any problematic results – with some limitations regarding the length of the questionnaire. The assessment of the reliability, generalisability, construct validity, criterion validity and diagnostic power of the single scales showed medium to good measuring qualities for the majority of the scales (i.e. Cronbach’s alpha mostly >0.7). In addition, the psychometric properties were very similar to those in the Danish COPSOQ-study. Considering all aspects of the measurement quality, a shortened version of the instrument was created. It attempts to combine measuring qualities as high as possible with a number of questions as low as possible. The German COPSOQ questionnaire is a free screening-instrument for the recording of psychosocial work load and strain for all enterprises and organisations interested. The next step is the construction of a "job exposure matrix" for psychosocial factors at work, that means a central database with work load profiles and reference values for as many occupational groups as possible.
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            The effects of job demands and control on employee attendance and satisfaction

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              Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences

              Background Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict – namely work interfering with family conflict (WIF) – which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made. Methods Data were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April–July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences. Results German hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, p < .01). No significant gender difference was found. Predictors for the WIF were lower age, high quantitative demands at work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, p < .01). High values of WIF were significantly correlated to higher rates of personal burnout, behavioural and cognitive stress symptoms, and the intention to leave the job. In contrast, low levels of WIF predicted higher job satisfaction, better self-judged general health status, better work ability, and higher satisfaction with life in general. Compared to the German general population, physicians showed significantly higher levels of individual stress and quality of life as well as lower levels for well-being. This has to be judged as an alerting finding regarding the state of physicians' health. Conclusion In our study, work interfering with family conflict (WIF) as part of Work-Family Conflict (WFC) was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.
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                Author and article information

                Journal
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central
                1472-6963
                2009
                13 August 2009
                : 9
                : 148
                Affiliations
                [1 ]Institute of Occupational Medicine, Charité - School of Medicine, Free University and Humboldt University, Thielallee 69-73, 14195 Berlin, Germany
                [2 ]Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
                [3 ]Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Department of Occupational Health Research, Pappelallee 35-37, 22089 Hamburg, Germany
                [4 ]Department of Medicine/Psychosomatics, Charité - School of Medicine, Free University and Humboldt University, Luisenstrasse 13a, 10117 Berlin, Germany
                Article
                1472-6963-9-148
                10.1186/1472-6963-9-148
                2735742
                19678932
                033ab7bc-fd78-4083-a838-ee3a16bae072
                Copyright © 2009 Mache et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 February 2009
                : 13 August 2009
                Categories
                Research Article

                Health & Social care
                Health & Social care

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