Job involvement of primary healthcare employees: does a service provision model play a role?

To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated.

A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis.

Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM.

Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.