Ballin, Cedric (2019) Activities promoting personal health potentials – Development of a priority concept for German general practitioners’ surgeries. DBA thesis, University of Gloucestershire. doi:10.46289/BNGH1478
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Text (Final thesis)
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Abstract
The focus for this research is health management in German general practitioners’ surgeries. In Germany, there are over 50,000 general practitioners’ surgeries with over 150,000 physician’s assistants as employees. One of the main objectives of health management is the reduction of absent days due to ill health and it is important to know, which activities can be identified to reach this objective. The overall aim of this research is to develop a concept to support stakeholders in promoting health supporting activities which facilitate personal health potentials and help improve the productivity of the general practitioners’ surgeries. The basis for the development of this concept was a systematic literature review, which indicated that health management in general could be improved by health promoting activities. However, the findings from the literature review reveal gaps in general practitioners’ surgeries health promotion practices. This research aims to improve the knowledge in health management at general practitioners’ surgeries in Germany with a focus on activities promoting the employees’ health potentials. The success of the proposed activities essentially depends on the acceptance by the employees. Therefore, a questionnaire about “health management” for employees of general practitioners’ surgeries has been developed which used the health-promoting measures found in the literature review. The findings of these questionnaires provide quantitative data (N=194) on which of the health promoting activities are preferred by the employees. The findings give an insight into personal preferences for health-promoting activities from the employee's point of view. The findings of the employee survey were used as indicator for the acceptance of activities; the results of the systematic literature review were used as indicator for the effectiveness. As a third indicator, the costs of the discussed activities have been incorporated into the concept. These three indicators form the basis for a multi-criteria decision analysis. Results were used to build a score for generating a priority list with ten effective activities promoting personal health potentials. The measures with the highest preferences are vaccines (94%), healthy food at work (67%), and training at home (61%). Robustness of the results was tested by means of a sensitivity analysis. Vaccination is widely ranked first in the priority list. This is of importance as the employees of general practitioner’s surgeries are exposed to substantial risk of infection. Three different strategies for implementing this concept into health management in general practitioners’ surgeries were developed. The main contribution to knowledge is seen in the contribution to the methodology. It shows how different perspectives of different stakeholders can be used in a systematic (and thus in a participatory, interaction-oriented and fair) decision-making process for health management that can be applied in other decision-making situations (e.g. hygiene or emergency management). As a theoretical contribution, the bridging of the implementation gap with the developed priority concept and its integration in an operational HRM model for German practitioners’ surgeries with the psychological contract as core are discussed.
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