Milena Vainieri, PhD, is Associate Professor in Management, Health and Management Lab, Institute of Management, Sant'Anna School of Advanced Studies of Pisa, Italy. E-mail:
Health Care Manage Rev. 2019 Jul/Sep;44(3):224-234. doi: 10.1097/HMR.0000000000000177.
The role played by remuneration strategies in motivating health care professionals is one of the most studied factors. Some studies of nursing home (NH) services, while considering wages and labor market characteristics, do not explicitly account for the influence of the contract itself.
This study investigates the relationship between the labor contracts applied in 62 Tuscan NHs and NH aides' job satisfaction with two aims: to investigate the impact of European contracts on employee satisfaction in health care services and to determine possible limitations of research not incorporating these contracts.
We apply a multilevel model to data gathered from a staff survey administered in 2014 to all employees of 62 NHs to analyze two levels: individual and NH. Labor contracts were introduced into the model as a variable of NH.
Findings show that the factors influencing nursing aides' satisfaction occur at both the individual and NH levels. Organizational characteristics explain 16% of the variation. For individual characteristics, foreign and temporary workers emerge as more satisfied than others. For NH variables, results indicate that the labor contract with the worst conditions is not associated with lower workers' satisfaction.
Although working conditions play a relevant role in the job satisfaction of aides, labor contracts do not seem to affect it. Interestingly, aides of the NHs with the contract having the best conditions register a significantly lower level of satisfaction compared to the NHs with the worst contract conditions. This suggests that organizational factors such as culture, team work, and other characteristics, which were not explicitly considered in this study, may be more powerful sources of worker satisfaction than labor contracts.
Our analysis has value as a management tool to consider alternative sources as well as the labor contract for employee incentives.
薪酬策略在激励医疗保健专业人员方面所扮演的角色是研究最多的因素之一。一些关于养老院（NH）服务的研究虽然考虑了工资和劳动力市场特征，但并未明确说明合同本身的影响。
本研究调查了在 62 家托斯卡纳 NH 中应用的劳动合同与 NH 助理工作满意度之间的关系，目的有二：一是研究欧洲合同对医疗保健服务中员工满意度的影响，二是确定不纳入这些合同的研究可能存在的局限性。
我们应用多水平模型对 2014 年对 62 家 NH 所有员工进行的员工调查数据进行分析，分析两个层次：个体和 NH。劳动合同作为 NH 的一个变量被引入模型。
研究结果表明，影响护理助理满意度的因素同时存在于个体和 NH 层面。组织特征解释了 16%的变化。对于个体特征，外国人和临时工比其他人更满意。对于 NH 变量，结果表明，条件最差的劳动合同与工人满意度较低无关。
尽管工作条件对助理的工作满意度起着重要作用，但劳动合同似乎并没有影响到它。有趣的是，与条件最差的劳动合同相比，NH 中劳动合同条件最好的 NH 助理的满意度显著较低。这表明，组织因素，如文化、团队合作和其他未在本研究中明确考虑的特征，可能是员工满意度的更有力来源，而不是劳动合同。
我们的分析作为一种管理工具具有价值，可以考虑替代激励员工的劳动合同的来源。
