Organizational justice in primary-care health centers and glycemic control in patients with type 2 diabetes.
BACKGROUND
Organizational justice has been put forward as a measure of leadership quality that is associated with better health among employees.


OBJECTIVE
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.


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


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


METHODS
: 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.


CONCLUSIONS
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.
Unit of Expertise in Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland. marianna.virtanen@ttl.fi
Marianna
M
Virtanen
Tuula
T
Oksanen
Ichiro
I
Kawachi
S V
SV
Subramanian
Marko
M
Elovainio
Sakari
S
Suominen
Anne
A
Linna
Anne
A
Koponen
Jaana
J
Pentti
Mika
M
Kivimäki
Jussi
J
Vahtera
D000368:Aged; D001291:Attitude of Health Personnel; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006442:Glycated Hemoglobin; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*
D006442:Glycated Hemoglobin