Centre for Work Life and Evaluation Studies (CTA) & Faculty of Odontology, Malmö University, Malmö, Sweden.
Centre for Workplace Excellence, University of South Australia, Adelaide, SA, Australia.
BMC Public Health. 2021 Jul 5;21(1):1320. doi: 10.1186/s12889-021-11320-8.
Welfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics.
The prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested.
High workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR = 0.93, p < .05, direct path from job satisfaction: OR = 0.89, p < .05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level.
Workplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.
像瑞典这样的福利社会在平衡预算的同时，面临着满足高质量医疗保健需求的挑战。本研究的目的是分析工作场所的社会资本是否可以预测牙科填充物的生存质量（通过临床工作人员的压力和/或工作满意度来衡量），并控制患者的人口统计学特征。
前瞻性设计包括 A）对 75 家普通公共牙科诊所的工作环境数据进行调查（基于 872 名个体评分的汇总数据），B）在调查期间的 3 个月内对 9381 颗牙齿的填充进行基于登记的生存分析，以及 C）患者的人口统计学特征（年龄、性别、收入水平和出生地）。使用多水平离散时间比例风险模型，我们检验了诊所层面的社会资本、压力和工作满意度是否可以预测牙齿填充失败，控制了患者的人口统计学特征。我们检验了一条直接路径和两条间接路径，由填充牙、位置和填充类型来调节。
高工作场所社会资本降低了磨牙早期填充物失败的风险，这是通过群体感知到的工作满意度来介导的（间接路径：OR=0.93，p<.05，直接路径来自工作满意度：OR=0.89，p<.05）。与预期相反，我们没有发现社会资本对护理质量有直接影响，也没有发现通过诊所层面的压力产生间接影响的证据。
工作场所社会资本通过提高工作满意度来提高牙科填充物的质量。此外，社会资本较高的诊所的工作人员报告的压力较小，工作满意度较高。这些结果表明，促进社会资本的发展可能会提高职业健康和护理质量。
