OpenUCT :: Browsing by Author "Pillay, Rubin"

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The effect of organisational structure and managerial practices on the clinical behaviour and job satisfaction of primary health care doctors, as knowledge workers, in the managed health care industry in South Africa
(2002) Pillay, Rubin; Horwitz, Frank
The financial crisis in the South African health care industry has forced participants in the industry to look for ways to contain costs. The subsequent deregulation of the private sector has resulted in the introduction and rapid growth of managed health care. This shift to a new paradigm were cost-effectiveness is a prerogative, has major implications for the doctor workforce. Due to concerns about the potential negative impact of this philosophy of health care delivery on the recruitment, retention and motivation of medical doctors, this study investigated the effect of managed care on their clinical performance and job satisfaction. A cross-sectional survey on a probability sample of 2023 general practitioners throughout South Africa was conducted using a mailed questionnaire. Exploratory factor analysis and internal consistency measures were used to assess the instrument's validity and reliability. Univariate, bivariate and multivariate statistical models were used to evaluate the organisational structures and managerial practices associated with managed care, and to assess the impact of these on the clinical freedom and job satisfaction of the respondents.