title: Developing and testing an instrument for identifying performance incentives in the Greek health care sector.
abstract: BACKGROUND
  In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity.
  
  
  METHODS
  A methodological exploratory design was employed in three phases: a) content development and assessment, which resulted in a 28-item instrument, b) pilot testing (N = 74) and c) field testing (N = 353). Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure.
  
  
  RESULTS
  Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied.
  
  
  CONCLUSIONS
  Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger sample of employees in the Greek healthcare system.
authors.affiliation: Faculty of Social Sciences, Hellenic Open University, Riga Fereou 169 & Tsamadou 26222 Patras, Greece. vipal@teiath.gr
authors.forename: Victoria
authors.initials: V
authors.lastname: Paleologou
authors.forename: Nick
authors.initials: N
authors.lastname: Kontodimopoulos
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Stamouli
authors.forename: Vassilis
authors.initials: V
authors.lastname: Aletras
authors.forename: Dimitris
authors.initials: D
authors.lastname: Niakas
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017598:Efficiency, Organizational / Q000331:legislation & jurisprudence*; D004649:Employee Incentive Plans; D005163:Factor Analysis, Statistical; D005260:Female; D006115:Greece; D006298:Health Services Administration / Q000331:legislation & jurisprudence*; D006302:Health Services Research; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008330:Management Audit; D008875:Middle Aged; D009042:Motivation; D011594:Psychometrics / Q000295:instrumentation*; D019984:Quality Indicators, Health Care; D012052:Reimbursement, Incentive; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000331:legislation & jurisprudence*