Antonella Cifalinò, PhD, is Associate Professor of Accounting, Università Cattolica del Sacro Cuore and CERISMAS, Milan, Italy. Daniele Mascia, PhD, is Associate Professor of Organization and Management Theory, University of Bologna, Italy. E-mail:
Health Care Manage Rev. 2020 Apr/Jun;45(2):117-129. doi: 10.1097/HMR.0000000000000206.
In many health systems, general practitioners (GPs) exhibit high levels of isolation and, at the same time, low levels of organizational identification, which can hinder their individual performance. The extant health care literature suggests that the physicians' belief that organizational goals are important, the adoption of performance measurement systems, and knowledge-sharing practices affect their individual performance. Most research has investigated these constructs in isolation, however, rather than explored their collective impact on GPs' individual performance.
The aim of this study was to explore how GPs' belief in goal importance, use of performance measures, and knowledge exchange affect their individual performance, here defined as their individual achievement of organizational goals.
We developed five hypotheses regarding how GPs' belief in goal importance and use of performance measures may affect individual performance, as well as how knowledge exchange may moderate these relationships. We tested our theoretical conjectures using data collected in a community of GPs in the Italian National Health Service. A survey questionnaire was administered to gather information about the GPs' level of belief in goal importance, use of performance measures, and perception about knowledge exchange in their primary care units. We considered two measures of GPs' individual performance: efficiency and appropriateness of drug prescription. We tested our hypotheses using probit regressions.
Our findings show that perceived importance of organizational goals and use of performance measures have a positive effect on GPs' individual performance. Meanwhile, GPs' use of performance measures moderates the relationship between their belief in goal importance and individual performance. Finally, perceived knowledge exchange moderates the relationships between belief in goal importance/use of performance measures and individual performance.
Executives could improve GPs' individual performance through interventions that reinforce their belief that organizational goals are important, facilitate a more intensive use of performance measures, and encourage knowledge exchange practices.
在许多医疗体系中，全科医生（GP）表现出高度的孤立感，同时组织认同感较低，这可能会影响他们的个人表现。现有的医疗保健文献表明，医生认为组织目标很重要、采用绩效衡量系统以及知识共享实践会影响他们的个人表现。然而，大多数研究都是孤立地调查这些结构，而不是探讨它们对全科医生个人表现的集体影响。
本研究旨在探讨全科医生对目标重要性的信念、使用绩效衡量以及知识交流如何影响他们的个人表现，这里将个人表现定义为他们对组织目标的个人实现程度。
我们提出了五个假设，涉及全科医生对目标重要性的信念和使用绩效衡量如何影响个人表现，以及知识交流如何调节这些关系。我们使用在意大利国家卫生服务的全科医生社区中收集的数据来检验我们的理论推测。我们通过问卷调查收集了关于全科医生在其初级保健单位对目标重要性的信念、使用绩效衡量以及对知识交流的看法的信息。我们考虑了两种衡量全科医生个人表现的指标：效率和药物处方的适当性。我们使用概率回归检验我们的假设。
我们的研究结果表明，组织目标的感知重要性和使用绩效衡量对全科医生的个人表现有积极影响。同时，全科医生对绩效衡量的使用调节了他们对目标重要性的信念与个人表现之间的关系。最后，感知知识交流调节了对目标重要性/使用绩效衡量与个人表现之间的关系。
通过强化他们对组织目标重要性的信念、促进更深入地使用绩效衡量系统以及鼓励知识共享实践，管理者可以提高全科医生的个人表现。
