Organizational justice in primary-care health centers and glycemic control in patients with type 2 diabetes.

Virtanen M, Oksanen T, Kawachi I, Subramanian SV, Elovainio M, Suominen S, Linna A, Koponen A, Pentti J, Kivimäki M, Vahtera J.

Source

Unit of Expertise in Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland. marianna.virtanen@ttl.fi

Abstract

BACKGROUND:

Organizational justice has been put forward as a measure of leadership quality that is associated with better health among employees.

OBJECTIVES:

We extended that idea to test whether perceived organizational justice among health care providers might be positively associated with glycemic control among their diabetic patients.

SETTING:

Eighteen primary-care health centers (HCs) in Finland.

PARTICIPANTS:

Type 2 diabetes patients (n=8954) and HC staff (n=422).

MEASUREMENTS:

: Mean of 1 year's measurements of glycated hemoglobin [≥ 7.0 (the least optimal); 6.5-6.9; 6.0-6.4; and 4.5-5.9 (the most optimal)], health-center psychosocial work characteristics (staff-reported procedural justice and relational justice, effort-reward imbalance, and work-unit team climate), and individual-level and work-unit-level covariates.

RESULTS:

Perceptions of higher levels of procedural justice among staff were associated with more optimal glycated hemoglobin levels among patients (cumulative odds ratio per 1-U increase in justice=1.54, 95% confidence interval, 1.08-2.18) after adjustment for patient-level and unit-level covariates. Relational justice, effort-reward imbalance, and work-unit team climate were not associated with glycemic control.

CONCLUSION:

The quality of leadership at HCs, as indicated by staff perceptions of procedural justice, may play a role in achieving good glycemic control among type 2 diabetes patients.