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doi:10.15678/ZP.2019.47.1.01
ZarządzaniePubliczne
PublicGovernance
No.1(47)/2019
ISSN1898-3529
VictorA.Pestoff
Workenvironment,governanceandservicequality
inJapanesehealthcare
Abstract
Objectives:ThispaperexploresthecontributionofgovernancetoworkenvironmentandservicequalityinJapanese
healthcare.
Researchdesign:Dataforthisprojectwascollectedbygivingquestionnairestothestaffateightcooperativehospitals
acrossJapanin2016andcomparedwithsimilardatafromthestaffattwopublichospitalsinOsakain2017.Thestaff
samplefromthese10hospitalswasatotalof6,859,witharesponserateof72.1%.
Findings:Basedonthe“demand,control,support”modelofKarasek&Theorell,wefoundthatmorestaffcontrolover
theirdailyworkliferesultedingreaterstaffsatisfactionandpromotedbetterservicequality.Governanceprovedto
beaninterveningfactorofsignificantimportanceandthispaperconsideredthreedifferentiatedmodelsforgoverning
theprovisionofhealthcareinJapan.Theyweredistinguishedintermsoftheautonomygiventothestaffintheir
everydayworklifeaswellaspatientinclusioninhospitaldiscussionsanddecision-making.
Implications:Greaterstaffautonomyandmorepatientinclusioncanhaveapositiveeffectbothonworkenvironment
andservicequality.Governancemodelscan,therefore,contributetoordetractfromgoalsofachievinggreaterstaff
autonomy,betterservicequalityandmorepatientinclusion.
Contribution:ThisstudytappedintoJapan’suniquehealthcaresystem,withtwouser-ownedco-operativehealthcare
providersthatmanagenearly200hospitalswithalmost50,000beds,inordertoexploreworkenvironment,governanceand
servicequality.Questionnairesgiventonearly7,000hospitalemployeesallowedustoexploreindepththecontribution
ofgovernancetoworkenvironmentandservicequalityinJapanesehealthcare.Theseresultscanserveasabestpractice
forotherhealthcareprovidersinJapanandelsewhere.
Articleclassification:researcharticle.
Keywords:workenvironment,demand&control,governance,servicequality,healthcare,co-operatives,socialenter-
prises.
JELclassification:I12&L31.
Introduction
Weber’sidealofmodernpublicbureaucracy
wasbasedonamilitary-likehierarchalcommand-
VictorA.Pestoff
ErstaSköndalBräckeUniversityCollege
Box11189,SE-10061Stockholm
victor.pestoff@esh.se
ORCID:0000-0001-8877-2731
and-controlmodel.Thismodelbecamethecentral
pointofreferenceforthedevelopmentofthepublic
sectorformostofthe20
th
Century.Itwasalso
adoptedasakeyorganisationalconceptbyin-
dustryandmanufactureinadvancedcountriesand
dominatedbusinessadministrationuntilrecently.
Yetitisincreasinglyapparentthatitisboth
inadequateandinappropriateinthe21stCentury,
ZarządzaniePubliczne/PublicGovernance1(47)/2019
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