[Work commitment of middle-line managers in health-care: Manageable organizational factors]

Middle-line managers are a key element in the management of health-care organizations. Reinforcing their commitment to their job could contribute to improving the health outcomes of the population they serve.

Analyzing the work commitment of middle-line managers to the health-care organizations they work for, as well as their profile and perception of the main manageable organizational factors involved.

Descriptive multicenter study based on a questionnaire about work commitment and 20 associated manageable factors, analyzing 60 variables (scale 1-10). The theoretical framework on which it was based was adapted from the model of demands and resources, along with 2organizational commitment questionnaires. It was distributed among the professionals of 23 non-profit health-care organizations belonging to the Health and Social Care Consortium of Catalonia, in the period 2015-2019.

A number of 2,060 surveys were obtained; 60% were answered by women; 69% declared an antiquity of more than 10 years. Cronbach's alpha coefficient was 0.974. The overall indicator of work commitment received 7.94 points. Overall, job resources received higher scores than demands (7.39 versus 6.69 points). The 3highest-scoring manageable organizational factors were demand, equality policies with 8.27 points, and 2resources: professional autonomy (7.81 points) and job stability (7.79 points). The 3lowest scoring factors were 3demands: Remuneration (5.52 points), time and personnel resources (5.74 points) and social benefits (6.10 points). Seventy-one percent of middle-line managers' work commitment to their institution was explained by 4manageable factors: Trust and coherence, professional autonomy, institutional image, and training and development.

The middle-line managers showed a high level of work commitment to their institutions. The main predictor of this commitment was the perception of trust in the institution and coherence in the management of the centers.