De Pourcq K., De Caluwe G., Gemmel P., Verleye K., Trybou J

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1 : Impact on Customer Oriented Behaviour and the Moderating Effects of Organizational and Professional Identification. De Pourcq K., De Caluwe G., Gemmel P., Verleye K., Trybou J

2 Caregiver-oriented model vs. Patient-centered care

3 The role of the physician

4 Previous research - Organizational members reciprocate perceived beneficial treatment of the organization with positive attitudes and behaviour (cfr. Social exchange) and economic exchange - No previous research have concentrated on the relationship between these two. - Most studies focused solely on the financial ties - In case of professionals, reciprocity is more complex than originally conceptualized - Social identification

5 Aim Testing economic en noneconomic exchange by examining relationships between: - Distributive Justice (DJ) which measures economic exchange - Perceived Organizational Support (POS) which measures non-economic exchange And Costumer-Oriented Boundary-Spanning Behaviours: - Internal Influence (II) - External Representation (ER) - Service Delivery (SD) Moderating variables that were tested: - Organizational Identification (OI) - Professional Identification (PI)

6 Models tested

7 Non-Economic exchange POS (Perceived Organizational Support) measures the global beliefs concerning the extent to which the organization values their contributions and their well-being (Eisenberger 1986).

8 Economic exchange Organizational Justice Distributive J: perceived justice of financial agreement

9 Costumer-Oriented Boundary-Spanning Behaviour Service Delivery (SD): Serving customers in a conscientious, responsive, flexible, and courteous manner (cf. Parasuraman et al. 1988) External Representation (ER): Being vocal advocates to outsiders of the organization s image, goods, and services (cf. Bowen & Schneider 1985) Internal Influence (II): Taking individual initiative in communications to the firm and co-workers to improve service delivery by the organization, co-workers, and oneself (cf. Schneider & Bowen 1984, Zeithaml et al. 1988)

10 Social Identification with the organization and with the profession Social identification is the perception of oneness with or belongingness to a group (Mael & Ashforth, 1992) Individuals define themselves in terms of their group membership and ascribe characteristics that are typical of the group to the self (Van Knippenberg, 2000) Social identification influences how the self is defined by group membership and, therefore, influences individual behavior (Hogg & Terry, 2000) Individual's self-concept C D B A Perceived identity of the profession Perceived identity of the hospital

11 Methodology self-employed physicians practicing at 6 Belgian hospitals (Response rate 17,1%) - Descriptive cross-sectional design analyzed by correlation analyses and a linear regression.

12 Findings Table1: Descriptive statistics, correlations and cronbach s alphas (diagonal) * = Correlation is significant at the 0,05 level (2-tailed) = Correlation is significant at the 0,01 level (2-tailed) ** = Correlation is significant at the 0,001 level (2-tailed)

13 Findings The results demonstrated: - A significant relationship between DJ and COBSB-ER (r = p < 0.001) and COBSB-II (r = p < 0.001). - A significant relationship between POS and COBSB-II (r = 0.458, p < 0.001) and COBSB-ER (r = 0.192, p = 0.033) - No significant relations between DJ and POS and COBSB-SD were present.

14 Findings Table 2: Regression analyses

15 Findings Regression analysis: - DJ explained 15.1% of variance in COBSB-ER (β = 0.381, p < 0.001) and 3.5% of variance in COBSB-II (β = 0.208, p = 0.020). - POS explained 22.0% of variance in COBSB-ER (β = 0.458, p < 0.001) and 3.2% of variance in COBS-II (β = 0.189, p = 0.026).

16 Findings - OI positively moderated the positive relationship of DJ with COBSB-ER (β = , p = 0.056). - OI reinforced the positive relationship of POS with COBSB- ER (β = , p = 0.045). - No moderating effects were present in the results of COBS- II. - PI did not moderate the studied relationships.

17 External Representation External Representation External Representation Findings Low OI High OI Low OI High OI 2.5 Low Distributive Justice High Low High Perceived 3 Organizational Support Low OI High OI 2.5 Low High Perceived Organizational Support

18 Discussion The outcomes of this study support the proposed model only partially. Economic and noneconomic exchange has indeed a significant impact on COBSB-ER and COBSB-II. Organizational identification positively moderates the relationship between economic and noneconomic exchange and COBSB-ER. Professional identification does not moderate the relationships between the perceptions of exchange and the customer-oriented behaviours of physicians.

19 Limitations and future research Cross-sectional design Convenience sample Respons rate Sample size Longitudinal study Other measures of COBSB

20 Conclusion Both economic and noneconomic exchange is important to self-employed physicians customeroriented behaviours (external representation and internal influence). However, neither have any impact on customer-oriented service delivery behaviour.

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