Doucette WR; Association for Health Services Research. Meeting.
Abstr Book Assoc Health Serv Res Meet. 1998; 15: 119-20.
College of Pharmacy, University of Iowa, Iowa City 52242, USA.
RESEARCH OBJECTIVES: As managed care organizations (MCOs) have exerted their influence on the utilization of health services, providers and suppliers of health care goods and services have sought to maintain market share by establishing strategic relations with key managed care customers. One strategy has been to use the principles of relational exchange, in which a long-term equitable relationship is developed between the parties. Under this approach, relational activities are performed to develop social bonds that enhance the value of the goods and services provided to the MCO. This paper examines the effects of pharmaceutical manufacturer relational activities on relationship outcomes, from an HMO perspective. STUDY DESIGN: A mail survey was sent to a national random sample of HMOs to assess the HMO's relationship with a pharmaceutical manufacturer. Pharmacy directors were targeted as key informants. Multi-item measures were developed for four relational activities (bi-directional communication, initiating behavior, flexibility, and participation) and five relationship outcomes (satisfactions, commitment, continuity of relations, financial performance, and equity). Reliability of the measures was assessed by coefficent alpha. A multiple regression analysis was performed for each relationship outcome, with the four relational activity measures as the independent variables. Of the 273 surveys delivered, 111 (40.7%) were returned and analyzed. PRINCIPAL FINDINGS: The reliability of the measures was acceptable, each with a coefficient alpha of at least 0.73. The regression models were significant for each of the relationship outcomes, with adjusted R2 values ranging from 0.50 (satisfaction) to 0.31 (equity). Bi-directional communication showed significant positive associations with four of the relationship outcomes (satisfaction, commitment, continuity of relations, equity), as did initiating behavior (satisfaction, commitment, continuity of relations, financial performance). Flexibility had significant positive associations with three relationship outcomes (commitment, financial performance, equity). Participation showed a significant positive association with financial performance only. CONCLUSIONS: Relational activities can contribute to favorable relationship outcomes. Bi-directional communication, initiating behavior, flexibility regarding contracts, and participation in joint planning can influence relationship outcomes such as satisfaction, commitment, continuity of relations, perceived financial performance, and equity. IMPLICATIONS FOR POLICY, DELIVERY, OR PRACTICE: The data here improved our understanding of HMO-pharmaceutical manufacturer relations. In addition, broader implications exist. One implication is that this theoretical approach could be used to investigate relations between MCOs and other providers, such as physician groups or integrated delivery systems. The relational exchange paradigm would be useful to study inter-provider relations within an integrated delivery system. Finally, it is feasible to research relational activities within MCO-employer relations. Better understanding of such interorganizational relationships could assist policy makers.
Publication Types:
Keywords:
- Communication
- Cooperative Behavior
- Data Collection
- Health Maintenance Organizations
- Managed Care Programs
- Pharmacies
- Physicians
- Regression Analysis
- economics
- hsrmtgs
Other ID:
UI: 102234218
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