Performance-based contracting related activities and its relationship with professional work across professional groups

The present study examines whether the time spent on performance-based contracting related activities, and satisfaction with this time distribution varies between professions in distinct institutional settings in health care, characterized by different degrees of professionalism. We also test a moderated-mediation model in which management support is expected to relate to the time spent on performance-based contracting related registration tasks and in which individual autonomy is expected to mediate the relationship between performance-based contracting related registration tasks and intrinsic job satisfaction. In this model the degree of professionalism is likely to influence the strength of the direct relationships between management support and performance-based contracting related registration tasks, between contracting related registration tasks and individual autonomy and between contracting related registration tasks and intrinsic job satisfaction. Using a survey of 91 home helps, 214 hospital nurses and 191 medical specialists (response rates 20%, 31%, 39% respectively), the findings corroborate with the idea that the way performance-based contracting is manifested differs across different institutional context in health care. Our results show that the amount of time spent on various performance-based contracting related registration tasks varies across the three professional groups. When it comes to satisfaction with time spend on performance-based contracting related registration activities, a finding of this study is that medical specialists are the least satisfied with all three forms of registration activities, regardless of the amount of time spent on it. The path analysis shows the importance of management support for levels of individual autonomy of professions characterized by lower degrees of professionalism. An unexpected finding of is this study is that we did not find any influence of time spent on performance-based contracting related registration tasks on individual autonomy or job satisfaction. Nor did we find an influence of management support on time spent on performance-based contracting related registration activities.