Unit-level fairness and quality within the health care industry: A justice–quality model

Abstract

We test a justice–quality model in which peer justice and justice climate are related to the service quality provided by the work unit. Based on the effort–reward imbalance model, we propose that units perceiving fair treatment provide better delivery of the core service (functional service quality) and better relational service beyond the core service (relational service quality). We also test whether the cross-level relationship of high service quality delivered by work units translates into high customer ratings of the service quality they receive. Furthermore, we propose that high service quality increases the work unit’s influence on their customers’ quality of life (QoL). We test these hypotheses using hierarchical linear modelling with 724 employees and 1,137 customers nested in 89 health care organizations providing services to persons with intellectual disabilities (PID). Customers’ ratings were assessed by the legal guardians of the PID. Results showed that justice climate is related to functional service quality, whereas peer justice is related to relational service quality. Additionally, results showed that high service quality delivered by work units relates to high customer ratings, which, in turn, are associated with the perceived influence of work units on customers’ QoL. We discuss the implications for justice and service research.

Keywords:

• Health care
• Justice climate
• Peer justice
• Quality of life
• Service quality
• Unit-level fairness

This research study was carried out under the projects supported by the Spanish Agency of Economy and Competitiveness [I+D+i project, PSI2010-21891 and PSI2013-48509] and European Regional Development Fund. The authors would like to thank Confederation of Organizations for Persons with Intellectual Disabilities (FEAPS) and associated centres that participated in the studies, especially professionals and families. The first author had a research grant “V Segles” of the University of Valencia.