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Health managers in B.C., part 2 : who manages our system? - sociodemographic characteristics, employment… Kazanjian, A.; Jackson, C.; Pagliccia, N. Jun 30, 1990

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.....HEALTH MANAGERS IN B.C.PART II: Who Manages OUr System?- Sociodemographic Characteristics, Employment Patterns,Educational Background and Training of Health ManagersHMRU 90:6Health Manpower Research UnitDivision of Health Services Research and DevelopmentOffice of the Coordinator of Health SciencesThe John F. McCreary Health Sciences CentreThe University of British ColumbiaVancouver, British ColumbiaV6T lZ6A. KazanjianC. JacksonN. PaglicciaJune 1990This report is one of a series describing the distribution of health manpowerand health care resources in British Columbia . These reports, prepared forthe Health Manpower Working Group of the Ministry of Health, are workingdocuments and comments or suggestions are welcome.' lr>THE l' \' [ V E R S [ T y' 0 F B R I T [ SHe o L L \ 1 B I .-\Health Manpower Research UnitDivision of Health ServicesResearch and Development1#400-2194 Health Sciences MallVancouver, B.C. Canada V6T lZ6Tel: (604) 228-4810Fax: (604) 228·2495June 25, 1990Ms. Vicki Farra11yChairpersonHealth Manpower Working GroupMinistry of Health1515 B1anshard StreetVictoria, B.C.V8W 3C8Dear Ms. Farra11y:It gives us great pleasure to submit to the Health Manpower Working Groupthe second report of the study on Health Managers in B.C. In this report wepresent the sociodemographic characteristics, educational background andtraining, employment patterns and career progress of Health Managers in B.C.All are part of the findings of the second phase of a two-stage mail survey ofcurrent supply. Data on income and job satisfaction are also included.We believe this to be the first attempt in Canada to compile acomprehensive profile of this group, describing who they are and what they do.We look forward to the completion of the third phase of this study wherean analysis of management tasks, management roles and the competencyrequirements for future managerial roles will be the focus. Suggestions orcomments are welcomed from the members of the Health Manpower Working Group.Sincerely yours,A·~2e5),I,-----·Arminee Kazanjian, Dr.Soc.Associate DirectorDivision of Health ServicesResearch and DevelopmentAssistant ProfessorDepartment of Health Careand EpidemiologyAK:daEncl.A Research Unit for the Health Manpower Working Group, Ministry of Health, British ColumbiaACKNOWLEDGEMENTSWe wish to extend our appreciation to the members of our SteeringCommittee who provided insight and advice in the area of organizationmanagement and promoted participation in the study among their respectiveassociation members .Representatives from the Canadian College of Health Service Executives,the Health Administrators' Association of B.C., the Ministry of Health, theB.C. Health Association, the B.C. Long Term Care Association, and theDepartment of Health Care and Epidemiology, U.B.C. served on this committee.Of course this project would not have been possible without the time andconsideration taken by the many respondents to this survey, to them we extendour utmost appreciation.TABLE OF CONTENTSList of TablesList of Figuresl. Introduction2. Future Management Challenges3. Objectives4. Identifying the Population5 . ~urvey Design and Methods6. Discussion of FindingsSociodemographic Profile of the Population- Educational Background and Training- Employment Patterns and Career Progress- Income Distribution and Job Satisfaction7. Summary and Concluding RemarksReferencesAppendices:Pageiiiv13671012121624394449Appendix A:Appendix B:Questionnaire and Cover LetterIncome and Job Satisfaction QuestionsA-lB-1•i iLIST OF TABLESPageTable 1 Number of Organizations Surveyed and Source of Informationby Sector 8Table 2 Eligible Respondent Organizations by Sector 11Table 3 Number. of Managers by Title of Position 11Table 4 Respondents by Type of Position and Sector, 1989 13Table 5 Respondents by Age and Sex, 1989 14Table 6 Respondents by Sector and Sex, 1989 17Table 7 Respondents by Position by Type of Post-SecondaryEducation, 1989 19Table 8 Responses by Type of Education and Year of Graduation, 1989 22Table 9 Responses by Sector and Type of Education, 1989 23Table 10 Respondents by Employment Status and Position, 1989 25Table 11 Percent Distribution of Respondents by Number of HoursWorked Per Week and Position, 1989 26Table 12 Percent Distribution of Respondents by Number of WeeksWorked Per Year and Position, 1989 27Table 13 Percent Distribution of Respondents by Position byNumber of Years in Present Position, 1989 30LIST OF TABLES (continued)iiiPageTable 14 Percent Distribution of Respondents by Position byNumber of Years in Any Managing Position in Healthcare 30Table 15 Percent Distribution of Respondents by Position byNumber of Years in the Healthcare System, 1989 31Table 16 Respondents by Position and Number of People Reportingto Them, 1989 31Table 17 Respondents by Position and Accountability for FinancialResources, 1989 33Table 18 Respondents by Position and Accountability for MaterialResources, 1989 33Table 19 Respondents by Position by Number of Projects Managed, 1989 34Table 20 Number of Respondents Who Are Currently the Principal orCo-Investigator of a Research Project by Sector, 1989 36Table 21 Respondents by Sector by Teaching Involvement, 1989 37Table 22 Time Currently Spent Per Month By Respondents on SelectedTasks Performed By a Health Manager 38Table 23 Percent Distribution of Respondents by Current Incomeand Position, 1989 42Table 24 Percent Distribution of Respondents by Current Income andEmployment Status, 1989 42Table 25 Job Satisfaction of Respondents by Sector 43Table 26 Job S4tisfaction of Respondents by Position 43ivLIST OF FIGURESFigure 1 Respondents by Age and Sex, 1989Figure 2 Respondents by Type of Position and Sex, 1989Figure 3 Respondents by Sector and Sex, 1989Figure 4 Respondents Who Have Completed a Post-SecondaryEducation by Position, 1989Figure 5 Respondents by Type of Post-Secondary Education, 1989Figure 6 Respondents by Position by Type of Post-SecondaryEducation, 1989Figure 7 Employment Status by Sex, 1989Figure 8 Respondents by Number of Hours Worked Per WeekFigure 9 Respondents by Number of Weeks Worked Per YearFigure 10 Union vs. Non-Union Positions by Title of Positionand Sex, 1989Figure 11 Respondents by Current Income and Sex, 1989Page1415171818202526272841HEALTH MANAGERS IN B.C.PART II: Who Manages Our System?- Sociodemographic Characteristics, Employment Patterns,Educational Background and Training of Health Managers1. IntroductionMost would agree that the role of health managers has changed extensivelyin the past several years, and that different skills and knowledge arerequired to meet the demands now placed on them. Recent developments thatsupport this position include: the provincial government's greater concernfor and closer management of the cost and quality of health care; rapidtechnological advances and increased use of 'high-tech' in health care; ashift in philosophy of care that is supportive of horizontal integration;increased pressure by some professional groups to be involved in decision-making processes at the facility or organization level.While an environment of constrained resources persisted in the '80s,health executives were under more pressure to 'manage better' - to do morewith less. It is, therefore, imperative that managers be adequately preparedboth at the entry-level and, insofar as continuing education is concerned, tomeet the system's changing needs. A useful assessment of changing humanresource needs should be based on information that is current, accurate andvalid.Despite the central role health managers play in the delivery of healthcare, a comprehensive profile of this group, or even a consensus of who theyare and what they do, does not exist in B.C. Some data for B.C. have been2available regarding Health Service Executives since 1983 (HMRU, 1984).However, these data have major limitations because they are derived from themembership lists supplied by three organizations: the Canadian College ofHealth Service Executives (CCHSE), the Health Administrators' Association ofBritish Columbia (RAABC) and the American College of Healthcare Executives(ACHE). The CCHSE is the sole source of comparable national data (Health andWelfare, 1988). In the absence of a regulatory body with a central registry,even taking a simple inventory of the number of personnel in practice becomesan onerous exercise.The first step towards accurately estimating manpower supply andrequirements entails developing an operational definition of the population ofinterest and compiling 'supply side' information on sociodemographiccharacteristics; after that, career patterns, patterns of professionaldevelopment, and functional tasks of the category under study can be examined.Present and future imbalances can thus be identified and this information willbe useful in estimating future educational needs, as well as for the purposesof human resources planning. A study to describe current supply was designedand commenced in the fall of 1988, with assistance from a Steering Committeeconstituting an expert panel. The Steering Committee members representedexpertise from the following organizations: the Health Administrators'Association of B.C.; the B.C. Health Association; the B.C. Long Term CareAssociation; the Health Services Planning and Administration Program, U.B.C.;the B.C. Ministry of Health; and the Canadian College of Health ServiceExecutives. The purpose of the study was to survey the population of interestand to produce a status report describing the personal and professional3characteristics of this group.Several Canadian studies of healthcare executives exist to date(Gosselin, 1988; Leatt, 1988; Storch, 1987; Meeks, 1983; Hastings et aI , 1981;Dixon, 1980; Hastings, 1976; McLeish and Nightingale, 1973). All of thesestudies, however, specify narrow definitions of the group under study, basedgenerally on one or two job titles and limited usually to acute carehospitals . Thus, simply replicating (where possible) or extending thesestudies ,was deemed inadequate . The objective of this study was to provide,for the first time, detailed information on the health managers of oneprovince, using a comprehensive yet precise definition, one that would be easyto quantify. In addition, the study was designed to solicit information onorganizational size and structure .2 . Future Mana&ement CballensesWhile more attention is being given to current and anticipated societalchanges such as population aging and increasing chronic illness, as well astheir implications for health and healthcare , very little has been writtenabout the management challenges of the future. Healthcare expendituresrepresent a significant proportion of the gross national product (StatisticsCanada, 1988), and as governments continue to be major purchasers of care,public accountability will continue to be a focal activity. Healthcareorganizations, functioning as corporate actors, are among the majorrepositories of power within the healthcare system. The collective decisionsof individual hospitals, multi-hospital systems, nursing homes, regulatorygroups, etc. can significantly affect the basic structure and characteristics4of services provided.Moreover, these organizations are operating in an environment that hasbecome increasingly complex and somewhat unpredictable in terms of futurechanges. With change will come a demand for greater organizationalresponsiveness and accountability from different groups, including healthmanagers. The health care organization's ability to adapt to divergent futuredemands will become increasingly important.Recently, more attention has been given to the issue of cost containmentat the agency level. A new trend, much more pro~ounced in the U.S. (Payne,1987; Wickizer et aI, 1989) but discernible also in Canada (Suttie et aI,1988), is the emergence of utilization review organizations. In B.C., theseefforts are still on a small scale, either at the hospital level (Shaughnessy)or at the hospital society level (VICARE , Victoria). The implications forhealthcare organizations are substantial. Undoubtedly, the organizations willcontinue to be under great pressure to control costs; however, simpleincentive programs can have only limited impact. In addition, appropriatenessof care and access are issues that require as much attention as does cost. Amore effective approach is likely to require structural changes in servicedelivery and a renewed sense of collaboration among the key professionals, thedoctor-nurse-manager team.Some attention is also being given to the issue of technologicaldevelopment and assessment. Again, the Canadian experience of technologydiffusion is appreciably different from that of the U.S., due to funding5differences. Still, technological development will have a continuing andincreasing impact on health services delivery. The use of minicomputers and1ithotripters, as well as the measurement of biochemical functions throughtechnology such as nuclear magnetic resonance imaging, is starting to changediagnosis and treatment. Questions about who makes the decision to acquirenew technology are currently being addressed (Deber et a1, 1988) , but otherquestions which will have serious implications for managers in the near futureare only at the formulation stage: Who will have access to new technologicaldevelop~ents? What effect will new technology have on provider-patientrelationships? What new ethical issues will be raised?In short, there is ample evidence that the role of the manager will haveto adapt to new and difficult challenges in the future. This will requireinnovative behaviour, the ability to manage external dependencies, and theability to restructure internal relationships. Unfortunately, one of themajor problems of health management has been the lack of iood indicators ofoperations and performance. Although attention has been given to financialmeasures of organizational performance, there has been little interest in thesystematic assessment of the human aspects of organizations (Seashore et al,1983). It would be useful to demonstrate the extent to which the efficientprovision of health services depends upon how well management personnelfunction independently in an organizational setting and collectively within aspecific sector.Our two-stage survey, although modest in scope, provides a first steptowards the compilation of baseline information for the assessment of the6human aspects of health organizations. Furthermore, it addresses a seriousconcern of health care management educators; that the indiscriminate teachingof concepts and management strategies from industrial settings needs closermonitoring and evaluation for application to health. Adequate preparation ofnew managers for health organizations of the future (and of those already inthe system through continuing education programs) warrants accurateinformation for rational educational planning purposes.3. ObjectivesThe main objective of this phase of the study was to compile accuratesupply-side information and to describe the sociodemographic characteristicsand employment patterns of health managers. As well, the current roles andfunctions of these personnel were examined in some detail, in order to examinethe evolution of these managerial roles from the roles documented in theliterature on human resources. A second objective, related to the first, wasto examine future directions in health management, as perceived by therespondents and expressed in terms of the skills and knowledge required tofulfill management roles of the future.The first phase of this manpower study was comprised of simultaneouslyidentifying the category/level of personnel and employers of such personnelfor inclusion in the survey.l Since the population of interest is defined as"those who manage the system" rather than "those who administer facilities", alSee Kazanjian, A., Pagliccia, N., and Jackson, C., Health Managersin B.C. Part I: Methods and Preliminaty F1ndinls From Survey of ChiefExecutive Officers; HMRU 89:2, July 1989.7comprehensive list of health agencies in B.C. was compiled. A two-stage mail­survey was undertaken; first, to identify individuals within the listedorganizations, according to the operational definition provided, and to obtaininformation on the stucture of these organizations and, second, to survey theidentified individuals (Appendix A). Data from the second survey (which arediscussed in this report) provide a sociodemographic profile of thepopulation, a synopsis of their employment experiences and career progress,and information on their educational background and training. A detailedsection on management tasks and management roles and on competencyrequirements for future managerial roles was also included in the survey. Theanalysis of these data by sector and size of org~nization is currently beingundertaken and will be reported separately.4. Identifyinl the PopulationHealth Managers in B.C. were identified systematically, with theassistance of an expert panel. Z Two steps were undertaken:1) The organizations which were considered to be healthcareorganizations for the purposes of the study were identified, and2) A method was designed to identify those individuals who would beclassified as health managers within each organization.In order to allow breadth of scope, at least in this first-stage survey,8TABLE 1NUMBER OF ORGANIZATIONS SURVEYED AND SOURCE OF INFORMATION BY SECTORSectors Number ofOrganizations ('iI) Source of InformationHospital 138 (10.5) B.C. List (1982), BritishColumbia List, 7th Edition,Jan. 1988, Sections 12-10 to12-27 and List of B.C. HospitalPrograms, Ministry of HealthRegional Hospital District 30 (2.3) :lli,g. , Sections 19-1 to 19-33Public Health Unit 28 (2.1) !Jlls!. , Sections 12-3 to 12-8Mental Health Centre 29 (2.2) 1lUJ;l. , Sections 12-8 to 12-9Continuing Care Agency 946 (72.3) B.C. Ministry of HealthProvincial Organization 34 (2.6) Information Services Vancouver,Directory of Services (The RedBook), 20th Edition, May 1988Professional/Volunteer Association 51 (3.9) llUJ;l.Federal Organization 19 (1. 5) Ibid.Consultants/Consulting Firm 29 (2.2) Health Manpower Research UnitAcademic 5 (0.4) Health Manpower Research UnitTOTAL 1,309 (100.0)9all health organizations in the province were included. Table 1 provides thenumber of organizations in each sector and the source of information for each.Four criteria for identifying individuals within organizations wereconsidered: i) job title; ii) job function; iii) normative judgement of ChiefExecutive Officer (CEO); iv) level of position in a hierarchical structure .Combining (ii), (iii) and (iv) was deemed the most appropriate for this study,as it incorporated both objective and subjective elements for defining thepopulation. More importantly, this method was considered free of the usualbias in favour of personnel from large organizations.The expert panel discussed at length an inventory of the many specificand general functions fulfilled by Health Managers in different settings, ascompiled from the literature. At a second meeting on the same subject, aconsensus was reached with respect to the four following functions:i) formulation and/or implementation of agency policies;ii) responsibility for personnel;iii) responsibility for agency-wide financial and/or material resources;iv) responsibility for managing agency-wide programs or projects.The study design thus allowed the Chief Executive Officer (or a person inan equivalent position) in each organization to use the above definition toidentify the managers in that organization/agency. These managers had to bein a remunerated position and had to perform one or more of the functionslisted above . The CEO was also given the opportunity to specify other10criteria for inclusion which were felt by him(her to be appropriate for thispurpose.5. Survey Design and MethodsA total of 1,309 organizations were identified in the first phase of thestudy (Table 1). In consultation with the expert panel, some organizationswere subsequently excluded from the study because managers, as defined by thestudy, were almost non-existent in these agencies. A total of 761organizations comprised our final population frame. The final useableresponses were 391, or 51.4 percent of the survey universe (see Table 2).The 391 responding organizations identified 1,982 personnel who fit thestudy definition of a "Health Manager" (Table 3) and who were eligible for thesecond survey. The second mail-survey followed in January, 1989. All thoseidentified for inclusion were surveyed on demographic, education andemployment characteristics (Appendix A). The intent of the second survey wasto obtain a representative sample of the population and, therefore, a highreturn rate was sought. The second survey yielded 1,203 final responses, aresponse rate of 61 percent.An additional section of the questionnaire was developed to solicitdetailed information on job satisfaction, managerial roles of the future, theknowledge and skills associated with each role, and the sources of competencefor these roles. Since this part of the questionnaire required a longer timeto complete and was expected to yield voluminous data, only a sub-sample ofthe managers (468 or 23.6%) were randomly selected to receive the full11TABLE 2ELIGIBLE RESPONDENT ORGANIZATIONS BY SECTORTotal Eligible RespondentsSector N % N %Hospital 138 18 .1 102 26.1Public Health Unit 28 3.7 18 4 .6Mental Health Centre 29 3 .8 15 3.8Continuing Care Agency 444 58.3 196 50 .1Provincial Organization 34 4.5 26 6 .6Professional/Vo1unteer Association 51 6.7 20 5.1Federal Organization 3 0.4 1 0.3Consultant/Consulting Firm 29 3.8 8 2 .0Academic 5 0 .7 5 1.3TOTAL 761 100.0 391 100 .0TABLE 3NUMBER OF MANAGERS BY TITLE OF POSITIONTitle Number of Managers PercentDirector 934 47.1Administrator 280 14.1Manager 268 13.5CEO/President 29 1.5Vice-President 36 1.8Other 435 21. 9TOTAL 1 ,982 100.012package. There were 230 final responses to the longer survey. This extensionof the routine manpower study will be analyzed and discussed in detail in PartIII of this report series.6. Discussion of FindingsTable 4 shows the distribution of respondents by position and sector .The majority (49.6%) of respondents are in a director's position. The largestproportion of directors (350 or 58.6%) is reported by the Hospital sector,followed by the Continuing Care sector (111 or 18.6%), and Provincial/FederalOrganizations (79 or 13.2%). Overall, 45.7 percent of all respondents work inthe Hospital sector and 27.5 percent work in the Continuing Care sector.Among the remaining sectors, the public service (Federal and Provincial)accounts for the largest proportion (12.6%).Sociodemographic Profile of the PopulationIn Table 5 we observe that the majority (57.6%) of respondents arefemale, compared to 42.4 percent male. More than one-third (37.8%) are 35-44years old and another 10 percent are younger than 35, indicating a relativelyyoung workforce. Examining the data disaggregated by five-year age groups(Figure 1), the largeat proportion of female respondents (20.4% and 20.3%) arebetween 40 - 44 years of age and 45 - 49 years of age, respectively. Males(24%) are largely between 40 - 44 years of age. Overall, the largestproportion of respondents (21.9%) are between 40 - 44 years of age. Examiningthe data by sex and type of position, we find that 55.2 percent (279) of themales are reported to be directors, in comparison with 45.7 percent (317) ofthe females (Figure 2). On the other hand, 17.3 percent of female respondentsTABLE 4RESPONDENTS BY TYPE OF POSITION AND SECTOR, 1989I SECTOR, II I 'Mental I Cont IProv/Fed IProf/Vol I I I I TotalPosition IHospita1 IPHUs IHea1th I Care I Org I Assoc. IConsu1tsiAcademiciOtheri N %, , , , , I 1 I 1 1Director I 350 I 10 I 18 111 I 79 I 16 I 3 I 5 I 5 I 597 49.6Administrator I 61 I 18 I 2 101 I 3 I 0 I 0 I 1 I 0 I 186 15 .5Manager I 56 I 7 I 0 33 1 35 I 6 I 2 I 0 I 0 1 139 11.6I 1 I 1 1 I I .....CEO/President I 10 I o I 0 2 I 0 I 1 I 5 I 0 I 0 I 18 1.5 wVice-President I 20 I o I 0 0 I 2 I 2 I 1 I 0 I 0 I 25 2.1Other I 53 I 23 I 7 84 I 32 I 8 I 23 I 8 I 0 I 238 19 .8, I I I 1 I I I ITOTAL N I 550 I 58 1 27 331 I 151 I 33 I 34 I 14 I 5 I 1203 100.0I I, I 45.7 14 . 8 I 2.2 27.5 I 12.6 I 2.7 I 2.8 I 1.2 I 0.4 I 100.014TABLE 5RESPONDENTS BY AGE AND SEX, 1989SexAge Male Female TotalN % N % N %S 34 46 9.2 72 10.6 118 10.035 - 44 194 38.8 252 37.1 446 37.845 - 54 161 32.2 250 36.8 411 34.855 - 64 87 17.4 99 14.6 186 15.865+ 12 2.4 7 1.0 19 1.6TOTAL 500 100.0 680 100.0 1180* 100.0(Row %) (42.4) (57.6) (100.0)*23 non-respondentsFigure 1Respondents By Age and Sex, 1989(N • 1180·)Agec2130-3431-38<40-44<41-4180-8451-1980-8<481·25 20 11 10 IMALEPrep.r.d by,H••lth M.npower R••••roh Unit. UBCo 8 10 15 20 25 PeroentFEMALE23 non-r••pond.nt.Figure 2Respondents By Type of Positionand Sex, 1989·(N = 1199*)Percent60......OMaie ~Female5040 1--.......LIlO VI V/' V/' V/' V/I V/I VIi I I I I i302010CEOIPresidentVice­PresidentManager Administrator Other 1 DirectorPrepared by: Health ManpowerRe.earch Unit, U.B.C.-4 non-re.pondents1 Include••upervl.ors, dept. heads, consultanle, etc.16(120) are administrators, compared to only 12.9 percent of males (65). Thereare also proportionately more female managers than male managers.Figure 3 gives a graphic depiction of the distribution of respondents bysector and sex. The data in Table 6 show that 37.3 percent of all femalerespondents work in the Continuing Care sector, compared to only 14.1 percentof males. As expected, the majority of both male and female (49 and 43.4%respectively) respondents work in the Hospital sector. While the numbers aresmall, more than four times as many female respondents were working in thearea of consulting as were male respondents. Overall, female respondentsworking in the Hospital sector comprise approximately 25 percent of totalrespondents; they are the largest single group of workers.Educational Background and TraininlThe educational profile of health managers by position showsoverwhelmingly that nearly all have completed some form of post-secondaryeducation (96%), as per Figure 4. Figure 5 looks at respondents by type ofpost-secondary education, revealing that 46.3 percent have completed auniversity undergraduate program, 39.7 percent have obtained a universitygraduate degree, and 29.4 percent have a community college or institute oftechnology diploma. In addition, 66.6 percent also reported having hadnOthern post-secondary education. This would include such areas as trade andvocational training, RIA, CGA and CRA certificates, etc. (Note thatrespondents can have more than one type of post-secondary education.) Table 7displays this information by position. The majority of all respondents havehad some form of training in the nOthern category. Among both CEO/Presidents17Figure 3Respondents By Sector and Sex, 1989(N • 1199*)•5040302010Percent_._ - - - _ __.._._._-- - - - _ .._- _ _ _._.f- - - - - _ ..._......-m F.m.l.o Mal.Ho.pltala PHU. M.nta' Cont Proy/Fed Prof/Vol Con.ult. Acad.mlo Oth.rHlth Ctr. Car. Or, A..oo. .Pr.p..... ~" H••I1~ ".np_rII••••r•• Unll. U•••O. •••• Talli••TABLE 6RESPONDENTS BY SECTOR AND SEX, 1989Male Female TotalSectorN , N , N %Hospital 248 49.0 301 43.4 549 45.8Public Health Unit 22 4.4 36 5.2 58 4.8Mental Health Centre 18 3.6 9 1.3 27 2.3Continuing Care Agency 71 14.1 259 37.3 330 27.5Federal Provincial Organization 109 21.6 40 5.8 149 12.4Professional/Volunteer Association 22 4.4 11 1.6 33 2.8Consulting Firm 6 1.2 28 4.0 34 2.8Academic 8 1.6 6 0.9 14 1.2Other 1 0.2 4 0.6 5 0.4TOTAL (N - 1199) 505 100.0 694 100.0 1199* 100.0* 4 non-respondents18Figure 4Respondents Who Have Completed aPost-Secondary Education By Position,1989(N • 1186-)Percent100908070805040302010oA.... lnl.t'.t., 0101p,..I".nlDI,••ta, M.n •••, VI••-P,•••P'.,1."" t1r'H••ltll M.nll_' R••••rall Unit. U.II.0.POlltlon·t. "."-''''1.M."tlt IllCIlu.....UII.,vl••,., d.,1t. "."'., O.".ultl"t., .ta.Figure 6Respondents By Type of Post-SecondaryEducation, 1989(N • 1185-)Percent708050403020100Community Un",.rllty Unlver.lty Other tC"olle,e Under,rad GraduateP"",.,, .."H••ltll M.nll.'" R••••rall Unit. U•••O.·t. "."-".,1.,,".nt.t l"oIU.... t,.do • 'IOo.tlon.1 t,.lnlnl, ItIA, OGA, CHA, .to.19TABLE 7RESPONDENTS BY POSITION BY TYPE or POST-SECONDARY EDUCATION, 1989Type of Post-Secondary EducationCommunity Undergraduate Graduate 1Position College Degree Degree Other" " " "Director 29.7 54.5 46.7 65.1N-593Administrator 25.4 37.0 28.2 95.0N-18lManager 38.8 35.1 23.9 61.9N-134CEO/President 33.3 61.1 61.1 61.1N-18Vice-President 8.0 76.0 76.0 92.0N-25Other2 30.8 38.5 37.6 53.8N-234TOTAL N - 1185*12 Includes trade and vocational training, RIA, CGA, CHA, etc.Includes supervisors, department heads, consultants, etc.* 18 non-respondentsFigure 6Respondents By Position By Typeof Post-Secondary Education, 1989(N • 1185*)Percent10080604020oNoDirector Administrator Manager CEOIPresidentPositionVice·PresidentOther 1immmi Community Collegeo Graduate DegreePr.p.r.d by,H.... h M.npow.r R••••rch Unit.U.S.C.~ Undergraduate DegreeOther 2-18 non-r••pond.nt.1 Inolud•••up.nl.or•• dept. he.ds, ccnsult.nts. elc.2 Include. tr.de & yoc.tlon.1 training. RIA. CGA. CHA. etc.21and Vice-Presidents, the largest proportion of respondents have universityundergraduate as well as graduate degrees (61.1% and 76% respectively). Amongmanagers, the largest proportion are Community College graduates (38.8%),followed by undergraduate degree holders (35.1%). Figure 6 provides a graphicdepiction of these data.According to the information summarized in Table 8, health managers withcommunity college or institute of technology diplomas had received them priorto 1975 (71.2%), a large proportion (22.0%) having graduated between 1956­1965. Holders of a university undergraduate degree tended to have obtainedthem after 1966 (76.8%), mostly between 1966-1970 (22.1%). Most respondentswith university graduate degrees report year of graduation as 1971 or after(66.6%), 21.8 percent having received their degrees between 1971-1975. Thesedata indicate an increasing requirement for higher formal qualifications forthis group .Since the Hospital sector is the largest employer, it is no surprise that49.2 percent of community college graduates, 46.5 percent of those withuniversity undergraduate degrees and 43.3 percent of those with universitygraduate degrees work in hospitals (Table 9). However, it is interesting tonote that 32.2 percent of community college graduates are employed in theContinuing Care sector, compared to only 16.2 percent and 17 percent of thosewith university undergraduate and graduate degrees. Approximately one-sixthof each of the last two groups is employed in Provincial/FederalOrganizations.TABLE 8RESPORSES BY 'l'YPE OF EDUCATION AND YEAR OF GRADUATION, 1989Before 1956 1956 - 1965 1966 - 1970 1971 - 1975 1976 - 1980 1981 - 1985 After 1985 TotalType of Education N"N"N"N"N , N"N"N %Community College orInstitute of Technology 36 10.2 78 22.0 68 19.2 70 19.8 53 15.0 30 8.5 19 5.4 354 100 .0University Undergraduate 31 5.6 99 17 .8 123 22.1 119 21.4 108 19.4 51 9.2 26 4.7 557 100.0University Graduate 27 5.6 58 12.1 75 15.7 104 21.8 94 19.7 79 16.5 41 8.6 478 100.0Other 41 8.1 109 21.5 79 15.6 53 10.5 58 11.5 92 18.2 74 14.6 506 100.0TOTAL 135 7.1 344 18.2 345 18.2 346 18.3 313 16.5 252 13.3 160 8.4 1895* 100.0* This figure is greater than the number of respondents due to multiple responses.'oJl oJ23TABLE 9RESPONSES BY SECTOR AND TYPE OF EDUCATION. 1989Community University UniversityCollege Undergraduate Graduate Other TotalSector N , N , N , N , N %Hospital 174 49 .2 259 46.5 207 43.3 255 50.4 895 47 .2Public Health Unit 17 4.8 34 6.1 32 6.7 22 4.3 105 5 .5Mental HealthCentre 5 1.4 20 3.6 24 5.0 7 1.4 56 3.0Continuing CareAgency 114 32.2 90 16.2 81 17.0 148 29.2 433 22.8Federal/ProvincialOrganization 30 8.5 93 16.7 81 17.0 53 10.5 257 13.6Pro f/Vo lunteerAssociation 5 1.4 20 3.6 14 2.9 6 1.2 45 2 .4Consultant 4 1.1 23 4.1 22 4.6 8 1.6 57 3.0Academic 3 0.8 14 2.5 12 2.5 6 1.2 35 1.8Other 2 0.6 4 0.7 5 1.0 1 0.2 12 0.6TOTAL 354 100.0 557 100.0 478 100.0 506 100.0 1895* 100.0* This figure is greater than the number of respondents due to multiple responses.24Employment Patterns and Career ProgressThe data indicate that most health managers in B.C. are salariedemployees. The majority of respondents (87.3 %) reported working on a full ­time basis (Table 10). Only 7.5 percent worked part-time and very few (4.5%)were self-employed. However, among the various positions, Managers were morelikely than all others to be in full-time employment. Conversely,CEO/Presidents were more likely than others to be self-employed and there wereno CEO/Presidents or Vice-Presidents who worked part-time. The largest numberof persons working part-time were associated with consulting firms.Employment status by sex (Figure 7) shows that twice as many females as maleswork part-time and that more males than females are self-employed.Most responses concerning employment patterns indicate a work week ofbetween 40 and 59 hours (55.3%), while 39.1 percent report working less than40 hours per week (see Figure 8 and Table 11). The remaining 5.6 percentreport a greater than 59-hour work week. These data indicate that largevariation exists by position; 83 percent of Vice-Presidents report a 40 to 59hour work week, whereas only 55.1 percent of Administrators report the samehours. Furthermore, while 17.6 percent of CEO/Presidents and 12.5 percent ofthe Vice-Presidents report working more than 59 hours per week, the proportionof respondents in other positions working more than 59 hours was appreciablyless. Employment patterns are very regular, with the majority (70.4%) workingmore than 47 weeks in the year, while another 24.5 percent work 40 to 47 weeks(Figure 9, Table 12).The majority (85.6%) of responding health managers hold non-union25TABLE 10RESPONDENTS BY EMPLOYMENT STATUS AND POSITION, 1989Employment StatusFull-Time Part-Time Self-Employed Other TotalPosition % % % % N %Director 91. 6 4.4 3.2 0.8 596 100.0Administrator 90.8 8.1 1.1 - 185 100.0Manager 93.5 4.3 1.4 0.7 138 100.0CEO/President 61.1 - 33.3 5.6 18 100 .0Vice-President 88.0 - 12.0 - 25 100.0Other1 71.7 18.5 9.4 0.4 233 100.0TOTAL N 1043 90 54 8 1195* 100.0(Row %) (87.3) (7.5) (4.5) (0.7) (100.0)1 Includes supervisors, department heads, consultants, etc.* Eight non-respondent.Figure 7Employment Status By Sex, 1989(N-1183*)Percent- -- - - -_ .__.---- -_..._- - --Male Female• Full-Time 0 Part-Time _ Self-EmployedPr.p.r.d bYIH••lth M.npower A••••rch Unit. UBC .20 non-,••pond.nt.26Figure 8Respondents By Number of HoursWorked Per Week(N • 1182*)Percenteo5040302010o(40 40-58Number of Hour./WeekTABU 11-11 "••-,••p ••d."t.PERCENT DISTaIBUTION or RESPONDENTSBY N'OHBER or HOUIS WOUlD PER wax. AND POSITION, 1989Hours Worked Per WeekPosition < 40 40 - 59 > 59 TotalDirector 34.8 58.9 6.3 100.0Administrator 41.1 55.1 3.8 100.0Manager 37.0 60.0 3.0 100.0CEO/President 17.6 64.7 17.6 100.0Vice-President 4.2 83.3 12.5 100.0Other 54.7 40.2 5.1 100.0TOTAL (N - 1182*) 39.1 55.3 5.6 100.0* Twenty-one non-respondents.27Figure 9Respondents By Number of WeeksWorked Per Year(N • 1160-)Percent)4740-47Numbe, of Weekal'Mar<408070805040302010o ...IL-......Iiii.WW::::WU;WW:::llllW.lI£.....__Pr.p.r.d by:Hultll M.npow.r A....roll Unit, U.S.C. ·"3 non-r••pond.nt.TABLE 12PEaCENT DISTRIBUTION OF RESPONDENTSBY NUHBD OF WEE1CS WORD» PEl. YU1l. AND POSITION. 1989tJeeks tJorked Per YearPosition < 40 40 - 47 > 47 TotalDirector 5.7 24.7 69.6 100.0Administrator 2.2 19.8 78.0 100.0Manager 4.5 22.4 73.1 100.0CEO/President 5.9 23.5 70.6 100.0Vice-President 4.0 24.0 72.0 100.0Other 6.2 29.2 64.6 100.0TOTAL (N - 1182*) 5 .1 24.5 70.4 100.0* Twenty-one non-respondents.28Figure 10Union vs. Non-Union PositionsBy Title of Position and Sex, 1989(N • 1190*)MalePercent1009080708050403020100Dlr.otorPercent100808070eo50403020100 D.,..to,AII.'nl.tr..., "an..., 0101Pr•• 'el••tPo,ltlon.u.... _N..-U....FemaleM.'II••t,..., ".11.'" CIOIProa.dolltPosition• UIlIOIl • NOII-UII'OIlVlo.-Pr•••Vloo­"roaldo.tOtll.,OtM'Pr.p.r.d bYIH••ltll ".npo••r R••••roll Unit. U.S.C. • 11 non-r••pond.nt.29positions (Figure 10). CEO/President and Vice-President are obviously non­union positions, whereas a small percentage of Directors, Administrators,Managers and "Other" are union positions. Looking at the union positions bysex, we find that 10.9 percent of the male Administrators are unionized,compared to only 7.5 percent of the females. However, the percentage ofunionized positions is higher for female Directors, Managers and "Other"(15.3%, 17.1% and 23.1% respectively) . The comparable figures for males areconsistently lower, especially for Manager positions.Surprisingly, more than half the respondents (58 .1%) have been in theirpresent position for five years or less; another 25.2 percent have been intheir present position 6 to 10 years (Table 13). Only one-sixth (16.7%) havebeen in the same position for more than ten years. While more than half(52.9%) of the CEO/President respondents have been in that position for fiveyears or less, more than one-quarter (29.4%) have been in that position formore than 10 years.An appreciable number of respondents have been in a managing position inhealthcare for 11 to 20 years (34.7%); while most CEO/Presidents fall in thiscategory (58.8%), Managers are less likely than others (23.9%) to have been inmanagement positions for 11-20 years (Table 14). Managers are more likelythan others to have been in managing positions in healthcare for five years orless, which suggests that this is an entry-level position for middle and highmanagers. Overall, 75 percent of all respondents have been in the healthcaresystem for more than 10 years; an appreciable number for more than 20 years(39.8%) (Table 15). All of the CEO/President respondents have been in30TABLE 13PERCENT DISTRIBUTION OF RESPONDENTSBY POSITION BY NUMBER OF YEARS IN PRESENT POSITION, 1989Number of YearsPosition S 5 6 - 10 11 - 20 > 20 TotalDirector 58.9 25.2 13.5 2.4 100.0Administrator 52.5 26.0 18.8 2.9 100.0Manager 56.0 31.3 7.5 5.2 100.0CEO/President 52.9 17.6 23.5 5.9 100.0Vice-President 64.0 24.0 12.0- 100.0Other 61.5 21. 7 14.6 2.2 100.0TOTAL (N - 1167*) 58.1 25.2 14.0 2.7 100.0* Thirty-six non-respondents.TABLE 14PERCENT DISTRIUBTION OF RESPONDENTS BY POSITIONBY NUMBER OF YEARS IN ANY MANAGING POSITION IN HEALTHCARENumber of YearsPosition S 5 6 - 10 11 - 20 > 20 TotalDirector 23.6 23.6 36.9 15.9 100.0Administrator 15.1 24.6 41.4 19.0 100.0Manager 34.3 28.4 23.9 13.4 100.0CEO/President 5.9-58.8 35.3 100.0Vice-President 12.5 25.0 45.9 16.7 100.0Other , 37.2 23.7 27.0 12.1 100.0TOTAL (N "" 1149*) 25.6 24.0 34.7 15.7 100.0* Fifty-four non-respondents.31TABLE 15PERCENT DISTRIBUTION or RESPONDENTS BY POSITIONBY NUMBER or YEARS IN THE HEALTHCARE SYSTEM, 1989Number of YearsPosition S 5 6 - 10 11 - 20 > 20 TotalDirector 10.7 11.2 36.6 41.5 100 .0Administrator 6.3 13.7 36.0 43.9 100.0Manager 18.0 20.3 33.6 28.2 100.0CEO/President- -58.8 41.2 100.0Vice-President 8.0 12.0 40.0 40.0 100.0Other 14.0 16.2 31.6 38.4 100.0TOTAL (N - 1146*) 11.3 13.4 35.6 39.8 100.0* Fifty-seven non-respondents.TABLE 16RESPONDENTS BY POSITION AND NUMBER or PEOPLE REPORTING TO THEM, 1989Number of People Reporting< 5 6 - 10 > 10 TotalPosition N , N , N , N ,Director 188 34.4 163 29.9 195 35.7 546 100 .0Administrator 54 30.9 76 43 .4 45 25.7 175 100.0Manager 57 47.9 31 26.1 31 26.1 119 100.0CEO/President 6 42.9 5 35.7 3 21.4 14 100 .0Vice-President 5 20.8 11 45.8 8 33.3 24 100 .0Other 68 37.2 41 22.4 74 40.4 183 100.0TOTAL 378 35.6 327 30.8 356 33.6 1061* 100 .0* 142 non-respondents.32healthcare for more than 10 years. Again, the data on Managers indicate thatthey are relative newcomers to healthcare, with 38.3 percent of this groupshowing 10 years or less of healthcare experience.Table 16 shows an even split in the number of people health managers havereporting to them: 35.6 percent have fewer than five people reporting; 30.8percent have 6 - 10 people reporting; and 33.6 percent have more than 10people reporting to them. Directors are more likely than any other singlegroup to have a large number of people reporting to them (the category "Other"is a heterogeneous group of positions); one-third (35.7%) reported beingresponsible for more than ten people, and they comprise 55 percent of thegroup with more than ten staff. In comparison, 43.4 percent of Administratorsreported being responsible for 6 - 10 people and 47.9 percent of Managersreported being responsible for fewer than 5 people, in keeping with their lesssenior positions.As shown in Table 17, most health managers are accountable for financialresources (82.9%); 53 percent of these are Directors, followed by a muchsmaller group of Administrators (17.3%). Both of these groups are slightlyover-represented in accountability for financial resources. An even largerproportion of health managers are accountable for material resources (84.7%),the majority (52.2%) of whom are in the position of Director (Table 18).Table 19 examines the many different programs, services or projects withwhich health managers have been involved in the last two years. Mostrespondents (50.4%) reported having managed more than four projects in the33TABLE 11RESPONDENTS BY POSITION AND ACCOUNTABILITY FOR FINANCIAL RESOURCES, 1989Accountable forFinancial ResourcesYes No TotalPosition N % N % N %Director 512 53.0 72 36.2 584 50.1Administrator 167 17.3 15 7.5 182 15.6Manager 108 11.2 22 11.1 130 11. 2CEO/President 15 1.5 2 1.0 17 1.4Vice-President 23 2.4 2 1.0 25 2.1Other 141 14 .6 86 43.2 227 19.5TOTAL 966 100.0 199 100.0 1165* 100.0(Row %) (82.9) (17.1) (100.0)* Thirty-eight non-respondents.TABLE 18RESPONDENTS BY POSITION AND ACCOUNTABILITY FOR MATERIAL RESOURCES, 1989Accountable forMaterial ResourcesYes No TotalPosition N , N , N %Director 511 52 .2 67 38.1 578 50.1Administrator 166 17 .0 16 9.1 182 15.8Manager 107 10.9 23 13.1 130 11.3CEO/President 16 1.6 1 0.6 17 1.4Vice-President 21 2.1 4 2.3 25 2.2Other 157 16.1 65 36.9 222 19.2TOTAL 978 100.0 176 100.0 1154* 100.0(Row %) (84.7) (15.3) (100.0)* Forty-nine non-respondents.34TABLE 19RESPONDENTS BY POSITION BY NUMBER OF PROJECTS MANAGED, 1989Number of Projects< 2 2 - 4 > 4 TotalPosition N % N % N % N %Director 51 11.1 149 32.5 259 56.4 459 100.0Administrator 21 15.2 64 46.4 53 38.4 138 100.0Manager 19 17.6 34 31.5 55 50.9 108 100 .0CEO/President- -6 46.2 7 53.8 13 100.0Vice-President --3 17.6 14 82.4 17 100.0Other 26 16.0 72 44.2 65 39.9 163 100.0TOTAL 117 13.0 328 36.5 453 50.4 898* 100.0* 305 non-respondents. (A number of respondents found this question not tobe applicable to them.)35last two years, 36.5 percent reported managing two to four, and 13 percentreported managing fewer than two programs, services, or projects in this timeframe. Disaggregated by position, 82.4 percent of all responding Vice­Presidents reported managing more than four projects in the last two years .Twenty-five percent of health managers responding to the survey reportedthat they were currently the principal or co-investigator of a researchproject (Table 20). There is little variation by position in the proportionof man~gers who do research. Of course, it is the information by sector whichwould be the determining factor for doing research or being a principal or co ­investigator. The majority (53.8%) of those in the Academic sector areengaged in research as principal investigators. An appreciable proportion ofconsulting firms, managers in Public Health Units and managers inProvincial/Federal Organizations are also engaged in research (38 .7%, 38.2%and 33.1% respectively). Few managers in Continuing Care Agencies are engagedin research (59 or 18.7%).Forty-five percent of health managers responding to the questionnairereported being involved in teaching within the last two years (Table 21). Thebreakdown by sector reveals that in some groups one-half of health managersare involved in teaching. Consulting Firms (54.8%), Mental Health Centres(48.0%) and Hospitals (46.9%) do a fair amount of teaching. Expectedly, theAcademic sector has the highest involvement in teaching (84.6%).The time currently spent per month by respondents on selected managerialtasks performed by a health manager is shown in Table 22. Overall, the36TABLE 20NUMBER OF RESPONDENTS WHO ARE CURRENTLY THE PRINCIPALOR CO -INVESTIGATOR OF A RESEARCH PROJECT BY SECTOR, 1989PRINCIPAL/CO-INVESTIGATORYES NO TOTALSECTOR N % N % N %Hospital 131 24.3 408 75.7 539 100.0Public Health Unit 21 38.2 . 34 61. 8 55 100 .0Mental Health Centre 6 22.2 21 77 .8 27 100.0Continuing Care Agency 59 18.7 257 81. 3 316 100.0Provincial/Federal Organization 49 33.1 99 66 .9 148 100.0ProfessionaljVolunteer Assoc. 8 25.8 23 74.2 31 100.0Consulting Firm 12 38 .7 19 61.3 31 100 .0Academic 7 53.8 6 46.2 13 100.0TOTAL 293 25.3 867 74.7 1160* 100 .0* Forty-three non-respondents.37TABLE 21RESPONDENTS BY SECTOR BY TEACHING INVOLVEMENT, 1989TEACHING INVOLVEMENTYES NO TOTALSECTOR N % N % N %Hospital 251 46.9 284 53.1 535 100 .0Public Health Unit 20 37.0 34 63 .0 54 100 .0Mental Health Centre 12 48.0 13 52 .0 25 100 .0Cont inuing Care Agency 138 43.8 177 56.2 315 100.0Provincial/Federal Organization 59 39.6 90 60.4 149 100.0Professiona1jVo1unteer Assoc. 13 41.9 18 58.1 31 100.0Consulting Firm 17 54.8 14 45 .2 31 100 .0Academic 11 84.6 2 15 .4 13 100 .0TOTAL 521 45 .2 632 54.8 1153* 100 .0* Fifty non-respondents.TABLE 22TIME CURRENTLY SPENT PER MONTH BY RESPONDENTS ONSELECTED TASKS PERFORMED BY A HEALTH MANAGERTIME CURRENTLY SPENT PER MONTHTASKS 0% 1-5% 6-10% 11-15% 16-20% >20% Total1. Personal oral communicationwithsu - 49.0 28.7 11.6 6.4 4.3 100.02. Personal oral communication with peers 0.1 45.9 30.4 13.3 6.1 4.2 100.03. Personal oral communication withsubordinates - 17.7 25.9 18.2 18.1 20.0 100.04. Group oral communication; at meetinas 0.1 35.5 29.8 13.5 10.7 10.3 100.05. Public speaking 0.7 87.1 8.2 2.3 0.5 1.2 100.06. Ustening-23.1 33.3 19.7 12.4 11.4 100.07. Report writing - 43.4 32.7 11.4 6.9 5.6 100.08. Letter writing - 65.1 24.9 5.3 2.9 1.8 100.09. Brief and memo writing- 53.5 32.7 8.7 3.9 1.2 100.010. Reading, study, analysis of technicalreports, iournals, etc. - 65.5 24.6 5.9 2.0 1.9 100.011. Readina, study, analysis of mail - 61.3 28.3 7.7 1.9 0.9 100.012. Analysis of information such asutilization data or financial research - 61.6 23.9 6.5 5.6 2.4 100.013. Other tasks - 28.7 20.0 12.0 9.3 30.0 100.0l.oJ0039majority of respondents spend at most 1-5 percent of their time on anyone ofthe tasks listed in thi~ table. Exceptions include: Task 3 (Personal OralCommunication with Subordinates), where most respondents (25.9%) spend 6-10percent of their time; Task 6 (Listening), where the majority of respondents(33.3%) also spend 6-10 percent of their time; and Task 13 (Other Tasks),where a large proportion of health managers (30%) spend more than 20 percentof their time each month. Results show that health managers tend to spend theleast amount of time in Task 5 (Public Speaking); 87.8 percent of allrespondents spend less than 5 percent of their time performing this task. Anaverage amount of time (6-10%) is spent by a majority (33.3%) of respondentsin dealing with Task 6 (Listening). However, the task which has been reportedby 56.3 percent of all respondents to take up most of their time each month(more than 10%) is Task 3 (Personal Oral Communication with Subordinates).Although the data are not shown here, 22.9 percent of respondents in theposition "Other" (which includes supervisors and department heads) spend over20 percent of their time on Task 3. A number of respondents who are Vice­Presidents, Managers and Directors also spend more than 20 percent of theirtime in this area (20.0%, 19.8% and 19.5%, respectively).Income Distribution and Job SatisfactionA last section added to the questionnaire was developed to solicitdetailed information on income, job satisfaction, managerial roles in thefuture, knowledge and skills associated with each role, and sources ofcompetence for these roles. Since this part of the questionnaire required alonger time to complete and was expected to yield voluminous data, only a sub­sample of those identified as managers received the full package. There were40230 final responses to this longer survey. This extension of the routinemanpower study will be analyzed and discussed in detail in Part III of thisreport series. In this report we will examine briefly only income and jobsatisfaction, since these are related to employment patterns and careerprogress.Variation of income by sex is reported by the respondents to thissection; while about one-third (31.3%) of female respondents report earningsof less than $35,000, the comparable figure for male respondents is fivepercent (Figure 11). Conversely, 17.5 percent of male respondents reportearnings greater than $75,000; the comparable percentage for femalerespondents is significantly smaller (3.1%). The data on income also showthat while 33.6 percent of the respondents report an income of $50,000 andmore, another 21.3 percent report an income of less than $35,000 (Table 23).Among the latter group 64.4 percent of those earning less than $35,000 workfull-time, 22.2 percent work part-time, and 13.3 percent are self-employed.However, when looking at all those working full-time, only 16.3 percent earnless than $35,000, while 59 percent of health managers who are working part­time earn less than $35,000 per year (Table 24).Among ten statements regarding respondents' experience with their jobs(Appendix B), statement ten focussed on job satisfaction using a 5-point scalethat ranged from "strongly disagree" (1) to "strongly agree" (5). In Table 25we look at average satisfaction score "by sector. Respondents fromProfessionaljVoluntary Associations "somewhat agreed" with statement ten,thereby scoring lowest in job satisfaction (4.0). Mental Health Centre••Figure 11Respondents By Current Incomeand Sex, 1989(N=211*)PercentOMal. _Female403530252015105o v r , , , / , ( / / /I i I I i I I I I I'35,000 35,000- 40,000- 46,000- 60 ,000- 66,000- 80,000- 86,000- 70,000- 76 ,000­38 ,888 44,888 48,888 64 ,888 68,888 84,888 88,888 74,888J>-Prepar.d by. H.alth Manpow.rR••••rch Unit , U.8.C.*19 missing ob.ervatlons - only those receivingthe long questlonnalr. answered this question.TABLE 23PERCEH'l' DISTRIBUTION OF RESPOHDERTS BY CORREN'l IHCOIIE AND POSITION, 1989<35,000 35,000 - 40,000 - 45,000 - 50,000 - 55,000 - 60,000 - 65,000 - 70,000 - 75,000+position 39,999 44,999 49,999 54,999 59,999 64,999 69,999 74,999 TotalDirector 11.5 6.7 28.8 14.4 7.7 9.6 7.7 3.8 1.9 7.7 100.0Administrator 24 .2 15 .2 12.1 18.2 9.1 6.1 6.1 3.0-6.1 100.0Manager 30.8 7.7 23.1 23.1 7.7 3.8 - - 3.8 - 100.0CEO/President-16.7 - - 16.7 - 16.7 - - . 50.0 100.0Vice-President- - - - 25.0 - - 25.0 25.0 25.0 100.0Other 44.7 10.5 15.8 7.9 5.3 2.6 2.6 - - 10.5 100.0TOTAL 21.3 9.0 21.8 14.2 8.1 6.6 5.7 2.8 1.9 8.5 100.0TABLE 24PERCBH'l' DIS'l'RIBUTIOH OF RESPONDIHI'S BY CORREN'l IHCOIIE AND EllPLOYIIEIft' STATUS, 1989Employment <35,000 35,000 - 40,000 - 45,000 - 50,000 - 55,000 - 60,000 - 65,000 - 70,000 - 75,000+Status 39,999 44,999 49,999 54,999 59,999 64,999 69,999 74,999 TotalFull-Time R , 16.3 9.6 24.7 15.2 9.0 7.3 6.2 3.4 1.7 6.7 100.0C , (64.4) (89.5) (95.7) (90.0) (94.1) (92.9) (91.7) (100.0) (75.0) (66.7) (100.0)Part-Time R , 58.8 5.9 5.9 5.9 - - - - - 23.5 100.0C , (22.2) (5.3) (2.2) (3.3) - - - - - (22.2) (100 .0)Self-Employed R , 37.5 6.3 6.3 12.5 6.3 6.3 6.3 - 6.3 12.5 100.0C , (13.3) (5.3) (2.2) (6.7) (5.9) (7.1) (8.3) - (25.0) (11.1) (100.0)TOTAL R , 21.3 9.0 21.8 14.2 8.1 6.6 5.7 2.8 1.9 8.5 100 .0C , (100.0) (100.0) (100.0) (100.0) ( 100.0) (100.0) (100.0) (100.0) (100.0) (100.0) (100.0)•+:­N43TABLE 25JOB SATISFACTION OF RESPONDENTS BY SECTOR(Respondents to Statement 10)- (N - 223)SECTOR (N) AVERAGE SATISFACTION SCOREHospital (99) 4 .3Public Health Unit (11) 4.5Mental Health Centre (6) 4 .8Continuing Care Agency (56) 4.4Provincial/Federal Organization (29) 4.1ProfessionaljVo1untary Assoc. (2) 4.0Consulting Firm (16) 4.1Academic (4) 4 .3TABLE 26JOB SATISFACTION OF RESPONDENTS BY POSITION(Respondauta to Stat••aut 10)(N - 223)POSITION (N) AVERAGE SATISFACTION SCOREDirector (107) 4.3Administrator (35) 4 .5Manager (25) 4.3CEO/President (7) 4.1Vice-President (6) 3 .8Other (43) 4.2Scale :StronglyDisagree1Disagree SomewhatSomewhat Uncertain Agree234StronglyAgree544respondents had the highest average job satisfaction score of 4.8. Onaverage, scores for this statement by position ranged from 3.8 to 4.5 (Table26). Respondents in Vice-President positions had the lowest averagesatisfaction score of 3.8 (between "uncertain" and "somewhat agree"), whileAdministrators had the highest score of 4.5 (between "somewhat agree" and"strongly agree").7. Summary and Concluding RemarksThis study represents a first step towards identifying and providing acomprehensive profile of health managers in British Columbia. We have begunto estimate current supply for this group by developing an operationaldefinition of a health manager and compiling 'supply side' information onsociodemographic characteristics, educational background and training,employment and career patterns, and income and job satisfaction. The majorfindings from this survey are summarized below.Over one-half of respondents were female (57.6%); the majority ofrespondents were between 40-44 years of age (21.9%).• Approximately one-half (49.6%) of all respondents were Directors(55.2 percent of male respondents); on the other hand, there wereslightly more female than male administrators and managers.• Overall, 45.8 percent of respondents worked in the Hospital sectorand 27.5 percent worked in the Continuing Care sector; approximately4525 percent of all respondents were females working in the Hospitalsector.Looking at the educational profile of health managers in B.C., wefound that 96 percent had completed some form of post-secondaryeducation; 46.3 percent had completed a university undergraduateprogram and 39 .7 percent had a university graduate degree.CEO/Presidents and Vice-Presidents had the largest proportion ofrespondents with both undergraduate and graduate university degrees(61.1% and 76%, respectively).Respondents with community college diplomas had received them priorto 1975 (71.2%), mostly between 1956 - 1965. Holders of auniversity undergraduate degree obtained them after 1966 (76 .8%),mostly between 1966 - 1970, and those with graduate degrees weremore likely to report year of graduation as after 1971 (66.6%).Responding health managers in B.C. tend to be employed full-time(87.3%). Twice as many females as males worked part-time and moremales than females were self-employed.Generally, respondents indicated a work week of between 40 and 59hours (55.3%). Vice-Presidents (83%) reported a 40 to 59 hour workweek, while 17.6 percent of CEO/Presidents report working more than59 hours per week.46The majority (85.6%) of responding health managers hold non-unionpositions.More than half the respondents (58.1%) have been in their presentposition for five years or less; only one-sixth have been in thesame position for more than ten years.The largest proportion of respondents has been in a managingposition in healthcare for 11 to 20 years (34.7%). Overall, 75percent of all respondents have been in the healthcare system formore than 10 years, an appreciable number for more than 20 years(39.8%).• Directors were more likely than others to have a large number ofpeople reporting to them; one-third (35.7%) stated that more thanten people reported to them. More than one-half of all the healthmanagers responsible for financial and material resources (53% and52.2% respectively) were Directors.One-half of all respondents reported managing more than fourprograms, services, or projects in the last two years.• Twenty-five percent of health managers who responded to the surveyreported themselves to be currently the principal or co-investigatorof a research project. The majority (53.8%) of managers in theAcademic sector were engaged in research. The Academic sector47(84.6%) also had the highest involvement in teaching. ConsultingFirms, Mental ·Heal t h Centres and Hospitals also reported a fairamount of teaching.• Fifty-six percent of respondents reported that more than 10 percentof their time each month is spent on Task 3 (Personal OralCommunication with Subordinates). However, the majority ofrespondents spend at most 1-5 percent of their time on anyone ofthe selected tasks.While 33.6 percent of the respondents reported an income of $50,000and more, another 21.3 percent reported an income of less than$35,000. While 31.3 percent of female respondents reported earningsof less than $35,000, the comparable figure for male respondents wasfive percent. Fifty-nine percent of health managers who are workingpart-time earn less than $35,000 per year.• Overall, health managers reported satisfaction with their presentpositions, showing relatively high average job satisfaction scores(3.8 to 4.5, out of 5).To date, profiles of health managers are few and often incomplete,despite the central role of these professionals in the delivery of health careand the relatively large numbers of personnel identified in the study. Thisreport has surveyed the population of interest and described the personal andprofessional characteristics of health managers in B.C., which was the main48objective of this phase of the study. However, it is not possible todelineate any specific trends related to this professional group or changes inpatterns of growth, since B.C. data for longitudinal analysis do not exist.The literature suggests, however, that the role of the health manager haschanged considerably in the past several years and that different skills andknowledge are required to meet the demands now placed on him or her;managerial roles have to respond quickly to the challenges of the future.These issues will be dealt with in the next phase of this study, where ananalysis of the management tasks, management roles and the competencyrequirements for future managerial roles will be the focus.49REFERENCES51Alexander, J.A.,~ (1986), "Organizational Growth , Survival and Deathin the U.S. Health Care Industry: A Population Ecology Perspective",Social Science and Medicine, 22(3):202-308.Alexander, Raymond S. (1981), "As Hospital Administrator" in Bellin, L.E.and Weeks L.E. (eds.), The Challenge of Administering Health Services:Career Pathways, Washington, D.C.: Association of University Programs inHealth Administration.Alexis, M. and Wilson, C. (1967), Organizational Decision-Making ,Englewood Cliffs, N.J.: Prentice-Hall.Argyris, C. (1964), Integrating the Individual and the Organization, NewYork: John Wiley & Sons.Barnard, C.I . (1938), The Functions of the Executive, Cambridge, Mass.:Harvard University Press.Baydin, L.D. and Sheldon, A. (1983), "Corporate Models in Health CareDelivery", in J.S . Rakich and K. Darr (eds.), Hospital Organization andManagement: Text and Readings , Jamaica, N.Y.: Spectrum Publications,Inc .Becker, S.W. and Gordon, G. (1966), "An Entrepreneurial Theory of FormalOrganizations", Administrative Science Quarterly, 11:315-344 .Bellin, L.E. and Weeks, L.E. (eds.) (1981), The Challenge of AdministeringHealth Services: Career Pathways, Washington, D.C.: Association ofUniversity Programs in Health Administration.Bergwall, D.F. (1978), "Role, Knowledge and Skill Requirements for ChiefExecutive Health Services Administrators of the Future", Doctor ofBusiness Administration Thesis, George Washington University.British Columbia Ministry of Health (1988), Minist[y of Health AnnualReport 1986/87, Victoria: Queen's Printer for British Columbia.Carroll, G. (1984), "Organizational Ecology", Annual Review of Sociology10:71-93.Child, J. (1983), "The Contribution of Organization Structure", in M.Lockett and R. Spear (eds.), Organizations as Systems, England: The OpenUniversity Press.Davis, M.M. (1929), Hospital Administration: A Career, New York.Deber, R.B., Thompson, G.G. and Leatt, P. (1988), "Technology Acquisitionin Canada: Control in a Regulated Market", International Journal ofTechnology Assessment in Health Care, 4:185-206.Dixon, M. (1980), Women in Health Administration in Canada, Department ofHealth Administration, University of Toronto, August.52Druker, P.F. (1974), "New Templates for Today's Organization", HarvardBusiness Review, Jan-Feb.Ellis, P.H. and Gaskin, P.M. (1988), "Sunnybrook's Matrix OrganizationalModel - Moving Ahead", Healthcare Management Forum, 1(2):12-15, Summer.Flood, A.B. and Scott, W.R. (1987), Hospital Structure and Performance,Baltimore: The John Hopkins University Press.Freidson, E. (1963), The Hospital in Modern Society, New York: Free Pressof Glencoe.Freidson, E. (1970), Professional Dominance: The Social Structure ofMedical Care, New York: Atherton Press.Freidson, E. (1986), Professional Powers: A Stu4y of theInstitutionalization of FOrmal Knowledge, Chicago: University of ChicagoPress.Glaser, B.G. (1978), Tbeoretical Sensitivity, C~lifornia: The SociologyPress.Gosselin, R. (1988), tiLe programme de formation en gestion pour lesmedecins et pharmaciens A l'Universite de Montreal", Healthcare ManagementEQIym, 1(2):20-22, Summer.Gouldner, A. (1954), Patterns of Industrial Bureaucraqy, New York: FreePress.Hage, J. (1980), Theories of Organizations: FOrm. Process. andTransfOrmation, New York: John Wiley-Interscience.Hannan, M.T. and Freeman, J.H. (1977), "The Population Ecology ofOrganizations", american Journal of SociololY, 82:929-964.Hastings, J.~ (1981), "Canadian Health Administrator Study", CanadianJournal of Public Health, 72 (Supplement 1), March-April.Hastings, J. (1976), Ontario Health Administrator Study, Department ofHealth Administration, University of Toronto, October .Health and Welfare Canada, Health Information Division (1988), HealthPersonnel in Canada 1987!Le PerSOnnel de la Sante 1987, Supply andServices Canada, Cat. No. Hl-9/1-l986.Heberlein, T.A. and Baumgartner, R. (1978), "Factors Affecting ResponseRates to Mailed Questionnaires: A Quantitative Analysis of the PublishedLiterature", American Sociological Review, 43(4):447-462.Hickson , D.J. et al (1971), "A Strategic Contingencies Theory of Intra­Organizational Power", Administrative Science Quarterly, 16:216-229.53Katz, E. and Kahn, R. (1966), The Social PsycholoiY of Organizations, NewYork: John Wiley & Sons.Knapp, S.E. and Lovejoy, R.R. (1973), Hospital Meriers in New England:Organizational Perspectives, Durham, N.H.: Systems Educators, Inc.Kovner, A.R. and Neuhauser, D. (1983), Health Services Management:Readings and Commentary, (2nd ed.), Ann Arbor: Health AdministrationPress ;Kuhl, I.K. (1977), The Executive Role in Health Service De1ivetyOrganizations, Washington, D.C.: Association of University Programs inHealth Administration.Leatt, P. (1988), "Management Partnerships: A Reaction", HealthcareManagement Forum, 1(2):21-24, Summer.Lewis, B.L. and Alexander, J. (1986), "A Taxonomy Analysis ofMultihospital Systems", Health Services Research, 21(1):29-56.Likert, R. (1967), The Human Organization, New York: McGraw-Hill.McGregor, D. (1960), The Human Side of Enterprise, New York: McGraw-Hill.McLeish, J. and Nightingale, D. (1973), Health Service Executive ManpowerNeeds for the Seventies in Canada, Department of Health and WelfareCanada, March.Meeks, J.R. (1983), "Occupational Self Concepts of Administrators inMedium and Large Sized Canadian Hospitals", DBA Thesis, George WashingtonUniversity.Merton, R.K. (1957), Social Tbeo[y and Social Structure, New York: FreePress.Meyer, J.W. and Scott, V.R. (1983), Orlanizational Enyironments: Ritualand Rationality, Beverly Hills, CA: Sage Publications.Mintzberg, H. (1973), the Nature of Manalerial Work, New York: Harper &Row.Mintzberg, H. (1979), the Structuring of Organizations, Englewood Cliffs,N.J.: Prentice-Hall, Inc.Mintzberg, H. (1984), "A Typology of Organizational Structure" in D.Miller and P.H. Friesen, Organizations: A Quantum View, Englewood Cliffs,N.J.: Prentice-Hall, Inc.Mooney, J.E. (1947), Principles of Orlanization, New York: Harper & Row .54Neuhauser, D. (1972), "The Hospital as a Matrix Organization", HospitalAdministration, l7(4):8~25.Newman, W.H. (1963), Administrative Action: The Techniques ofOrganization and Management, (2nd ed.), Englewood Cliffs, N.J.: Prentice­Hall.Payne, S.M.C. (1987), "Identifying and Managing Inappropriate HospitalUtilization: A Policy Synthesis", Health Services Research, 22(5):70~­769.Perrow, C. (1967), "A Framework for the Comparative Analysis ofOrganizations", American Sociological Review, 32:194-208.Peters, J.P. and Tseng, S. (1983), Mana&ini Strategic Chanie in Hospitals:Ten Success Stories, Chicago: American Hospital Association.Pfeffer, J. (1981), Power in Organizations, Marshfield, Mass.: PitmanPublishing.Provan, K.G. (1984), "Interorganizational Cooperation and Decision-MakingAutonomy in a Consortium Multihospital System", Academy of ManagementReyiew, 9:494-504.Roethlisberger, F.J. and Dickson, W.J. (1947), Management and the Worker,Cambridge, Mass.: Harvard University Press.Scott, W.R. (1981), Organizations: Rational. Natural. and Open Systems,Englewood Cliffs, N.J.: Prentice-Hall .Scott, W.R. (1981), "Developments in Organization Theory, 1960-1980",American Behavioral Scientist, 24:407-422.Scott, W.R. (1980), "Introduction to Part One: Theoretical · Perspectives",in M.W. Meyer~ (eds.), EnvirOnments and Organizations, San Francisco:Jossey-Bass.Seashore, S .E.~ (1983), Assessing Organizational Change: A Guide toMethods. Measures and Practices, New York: John Wiley & Sons.Selznick, P. (1966), TVA and Tbe Grass Roots, New York: Harper &Row.Shortell, S.M. and Kaluzny, A.D. (1988), Health Care Management: A Textin Organization Theory and Behaviour, New York: John Wiley & Sons.Simon, H. (1965), Administrative Behayiour, (2nd ed.), New York: FreePress.Snook, I .D. (Jr.) (1987), "Hospital Organization and Management", in L.F .Wooper and J.J. Pena (eds.), Health Care Administration: Principles andPractices, Rockville, Maryland: Aspen Publications, Inc.55Statistics Canada, Canadian Economic Observer, Catalogue 11-010 Monthly,Ottawa: Minister of SUEPly and Services Canada. GNP Statistics prior toJanuary 1988 are available in: Statistics Canada, Canadian StatisticalReview, Catalogue 11-003E, Ottawa: Minister of Supply and ServicesCanada.Storch, J.L. (1987), "Correlates of the Occupational Role Identity of anOrganizational Professional: A Study of Canadian HospitalAdministrators", Ph.D. Thesis, University of Alberta.Suttie, B., Helliwell, B., Villenure, D. (1988), Some Aspects ofUtilization Management in Twenty Ontario Hospitals, Yaterloo, Ontario:Centre for Applied Health Research.Taylor, F. (1947), Scientific Management, New York: Harper & Row.Thompson~ J.D. (1967), Orianizations in Action, New York: McGraw Hill.Yeber, M. (1964), The Theory of Social and Economic Organizations,Glencoe, Illinois: Free Press.Yickizer, T.M., Wheeler, J.R.C. and Feldstein, P.J. (1989), "DoesUtilization Review Reduce Unnecessary Hospital Care and Contain Costs?",Medical Care, 27(6):632-647.Yilliamson, O.E. (1981), "The Economics of Organization: The TransactionCost Approach", American JOUrnal of Sociology, 87:548-577.•A-lAPPENDIX AQuestionnaire and Cover LetterA-2THE UNIVERSITY OF BRITISH COLUMBIAHealth Manpower Research UnitDIvision of Health ServicesResearch and Development1400-2194 Health Sciences MallVancouver. B.C. Canada V6T IZ6Telephone (604) 228-4810Fax (604) 228-2495January 20, 1988Dear Respondent:In collaboration with the B.C. Long Term Care Association, the B.C.Health Association (BCHA) , the Canadian College of Health ServiceExecutives (CCHSE), the Health Administrators Association of B.C. (HAABC) ,and the UBC Health Services Planning and Administration Program, we arecurrently undertaking a manpower study of Health Managers in B.C. Thepurpose of this study is to compile accurate "supply side" information onsociodemographic characteristics, describe professional development andcareer patterns, and to clearly delineate future managerial roles. Theensuing report will be submitted to the Health Manpower Working Group ofthe Ministry of Health.The enclosed questionnaire is designed to solicit detailedinformation on all of the above-mentioned areas in the most efficient waypossible and without compromising the reliability of study findings.Therefore, Part I - comprising questions on demographic, education andemployment characteristics - is being sent to all health managementpersonnel. Part II is being sent to only a random sample of healthmanagement personnel, and contains questions on perceptions of futuremanagerial roles and on detailed knowledge and skills required to fulfillthese roles.As you can probably guess, a very high rate of response is essentialto the success of this study . We will be able to infer very little aboutthe non-respondents, and anything less than a census will, by definition,provide an incomplete picture of the supply situation. In short, yourkind cooperation is essential to the success of this project. While itgoes without saying that you have every right to decline our invitation toparticipate, and this choice should not put you in a position of jeopardy,we are hopeful that you will recognize the importance of the study andwill be · willing to assist us.. .. /2A Research Unit for the Health Manpower Working Croup, MinistrY of Health, British ColumbiaA-3• 2 -The amount of time required to complete the questionnaires is 10minutes if you have received only Part 1, and 45 minutes if you havereceived Parts I and II. The returned questionnaire in the stamped,self-addressed envelope will be taken as your consent to participate inthis study, but will also represent the total commitment required of you .There will be no further contact or questionnaires. Your informationand identity will be strictly confidential and only accessible toresearchers directly involved in the study. Results on individuals willnot be published or appear in working documents.If you have any questions please feel free to contact me at 228-4618or Nino Pagliccia at 228-5009.Thank you in advance for your cooperation.Si4~1Z2~12__Arminee KazanjianActing DirectorDivision of Health ServicesResearch and DevelopmentAK:daEncl.A- 4ID #600032[1 - 8]HEALTH MANPOWER RESEARCH UNITSURVEY OF HEALTH MANAGERS IN B.C.Name _Title of Position _Agency _If the name, title of your position and/or agency is not correct,please make corrections below:NameTitle of positionAgencyREC 01PERSONAL [9 - 10]Sex: Male Female [11]1 2Year of birth: 19 [12 - 13]Is your position a union position? Yes No [14]1 2Have you completed your secondary education? Yes1No2[15]EDUCATIONPlease provide I n f o r ma t i o n on your formal post-secondary education.INCLUDE ALL SCHOOLING AND CREDENTIALS . PLEASE PRINT CLEARLY .TYPE LOCATION OF NO. OF PROGRAM OR DEGREE/DIPLOMA/OF NAME OF INST nUT ION YEARS FIELO OF CERTIFICATE YE AREDUCATION INSTI TUTION (PROV ./COUNTRY) ATTENDED SPECIALIZATION RECEIVED REC'O[11 - 30J [3 t - 40] [4 t - 42} (43 - 52] [53 - 62] [63 - 66]Communtty College t.orInstitute of 2 .Technology3.t.UniversityUndergraduate 2 .3 .t.UniversityGraduate 2 .3 .Other (e .g . trade ,vocational train-Ing, RIA. CGA , CHAcertificate, etc .)(Please spec ify)[9 - to!REC 02REC 03REC 04REC 05REC 06»-IREC 01 VIREC 08REC 09REC 10REC 11REC 12REC 13REC 14A-6E~PLOYMENT STATUS\\~ i ch of the following describes your current status of employment?IF NORE THAN ONE EMPLOYMENT, PLEASE REFER ONLY TO YOUR PRINCIPALEHPLOYMENT. ASSUME AS PRINCIPAL THAT EMPLOYMENT WHICH TAKES MOST OFYOUR WORKING TIME.REC 15[9 - 10 ;1. Full-time salaried position in healthcare system[GO TO QUESTION C AND REST OF QUESTIONNAIRE) 12. Part-time salaried position in healthcare system[CONTINUE WITH QUESTIONS B AND C AND REST OF 2QUESTIONNAIRE)3. Self-employed in healthcare system[CO~TI~~E WITH QUESTIONS B AND C AND REST OF 3QlJESTIONNAIRE)4. Employed, but not in healthcare system[GO TO QUESTION B AND STOP) 4• 5 . Not employed[GO TO QUESTION B AND STOP) 56. Retired[STOP HERE) 6 (11)B. [ONLY if you . checked 2, 3, 4 or 5 in A]If you have more than one employment, are All of them combinedequivalent to a full-time employment?Yes1No _2 [12]Are you currently seeking full-time employment in the health caresystem?Yes1No _2 [13]IF NOT EMPLOYED OR NOT EMPLOYED IN HEALTHCARE , STOP HERE. THANK YOU.IF YOUR PRINCIPAL POSITION IS IN HEALTHCARE, PLEASE CONTINUE WITH C ANDREST OF QUESTIONNAIRE . .A-7C. :r:OR THE FOLLOWING QUESTIONS, PLEASE INCLUDE ~ POSITIONS INHEALTHCARE)\\~at wa~ the average number of hours you normally worked per weekduring the last 12 months?What was the number of weeks you worked during the last 12 months?The following is a list of tasks that might be performed by a healthmanager. Please indicate, in Column 1, what percentage of your time (toadd up to 100%), in a typical month, you currently spend on each task;and, in Column 2 what percentage of your time should ideally (optimally)be spent on each task.i% Time % TimeTasks (Current) (Ideal)-"---l. Personal oral communication withsupervisors2. Personal oral communication with peers') Personal oral communication with..I.subor ddnatie s4. Group oral communication; at meetings5. Public Speaking6. Listening7. Report writing8. Letter writing9 Brief and memo writing10. Reading, study, analysis of technicalreports, journals, etc.(continue on next page)[14 - 15J[16 - 17)[18-20]/[21-23)[24-26]/[27-29][30-32]/[33-35][36-38]/[39-41][42-44]/[45-47][48-50]/[51-52][53-55]/[56-58][59-61]/[62-64][65-67]/[68-70)[71-73]/[74-76]A-8-I % Time % TimeI Tasks (Current) (Ideal)1I1 ( c o n t Lnue d)i11 . Reading, study, analysis of mail12. Analysis of information such asu c LaLz a c i on data or financial research13. Other tasks (please specify)TOTAL 100% 100%y EMPLOYMENT INFORMATION: FOR THE FOLLOWING QUESTIONS, PLEASE REFER TO PRINCIPAL POSITION INHEALTHCARE ONLY]How many people in the organization directly report to you?[77-79 ]/[80 -82 ;[83-85]/[86-88][89-91 ]/[92 -94 ][95-97]/[98-100][101-102]/[104-106]REG 16[9 - 10][11 - 12]rtre you accountable for financial resources? Yes1No2[13]Are you accountable for material resources? Yes1No2[14]How many different programs, services or projectshave you managed in the last two years? [15 - 16]Have you been, in the last two years, orare you currently the principal or co­investigator or a research project?Ha-. c you been, in the last two years,or are you currently involved inteaching?YesYes11No _2No2[17 ][18]A-9WORK EXPERIENCE[ONLY WITHIN HEALTHCARE SYSTEM]When did you start work~ng in your present principal healthcareposition?Month __Year 19When did you first start working in any managing position inhealthcare?Month _Year 19When did you first start working in any (managing or non-managing)position within the health care system?MonthYear 19What was the title of the healthcare managing position you heldprevious to the current one? (NA if not a managing position)Please print clearly .[19 - 20 )[21 . 22][23 - 24][25 • 26][27 - 28][29 - 30][31 - 60]r•A-10I f vov ~ould like to receive a summary of the final reportof ~h is r e s earch study , please check the appropr iate space1COMMENTSTHANK YOU VERY MUCH FOR YOUR COOPERATION(Please return the questionnaire in the enclosed, stamped, self-addressed envelope)Prepared by :Health Manpower Research UnitThe University of British Columbia••••..B-1APPENDIX BIncome and Job Satisfaction Questions•••••B-2INCOME[We would like to remind you that all the information you provideis strictly confidential.]Please circle the number for the income corresponding to your currentannual income. [PLEASE INCLUDE ALL POSITIONS IN HEALTHCARE]< 35,000 135,000 - 39,999 240,000 - 44,999 345,000 - 49,999 450,000 - 54,999 555,000 - 59,999 660,000 - 64,999 765,000 - 69,999 870,000 - 74,999 975,000 + 10Please check the income bracket corresponding to the annual income thatyou had five years ago (only if you worked in the healthcare system)REC 46[9 . 10][11 - 12]••< 35,00035,000 - 39,99940,000 - 44,99945,000 - 49,99950,000 - 54,99955,000 - 59,99960,000 - 64,99965,000 - 69,99970,000 - 74,99975,000 +12345678910 [13 - 14]I was not working in the health­care system five years ago1Please check the income bracket corresponding to the annual income,in dollars, you will expect to earn in five years within the healthcaresystem.[15]< 35,00035,000 - 39,99940,000 • 44,99945,000 - 49,99950,000 - 54,99955,000 . 59,99960,000 - 64,99965,000 • 69,99970,000 • 74,99975,000 +12345678910 [16 . 17]I do not expect to be working inthe hea1thcare system in fiveyears 1 [18]B-3JOB SATISFACTIONListed below are some statements about job satisfaction. Please read each statement andcheck the box corresponding to your feeling about it, from "strongly disagree" to"strongly agree". [PLEASE REFER TO YOUR PRINCIPAL POSITION AND TO YOUR EXPERIENCE IN THEPAST SIX MONTHS]"..(1) (2) (3) (4) (5)REC 17[9 - 10)Strongly Disagree Un- Somewhat StronglyDisagree Somewhat certain Agree Agree1. Considering what is expectedof me, the pay I get isreasonable.2. If I had ,to do it over again,I would still go into healthmanagement.3. There is no doubt in my mindthat what I do is reallyimportant.4. I have all the voice inplanning policies and pro-cedures in my 'job that Iwant.5. There is not enough team-work/communication betweenmanagement and staff.6. I feel I am supervised moreclosely than I want to be.7. There is too much "paperwork"required of me.8. I have the freedom in my workto make important decisions,as I see fit, and can counton my supervisors to back meup.9. There is a good deal of team-work/co~unicationbetweenme and various levels ofmanagement.10. All in all I am quite satis-fied with my job.(11)(12)(13) ..•(14)(15)(16)(17)(18)(19)q(20)


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