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标题：Development and Validation of Instrument Measuring Perception of Healthcare Provider on Cost Containment and Related Practices in Hospital Setting
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作者：Randa Khirfan ; Aniza Abd Aziz ; Zainuddin Awang 等
期刊名称：International Journal of Academic Research in Business and Social Sciences
电子版ISSN：2222-6990
出版年度：2022
卷号：12
期号：4
页码：588-607
DOI：10.6007/IJARBSS/v12-i4/13094
语种：English
出版社：Human Resource Management Academic Research Society
摘要：Introduction: Healthcare system is struggling to overcome challenges in cost-containment and to maintain expenditure levels conceivable for an efficient operation. A new instrument measuring cost containment practices in healthcare are essential to provide genuine information to prevent unnecessary expenses and excessive spending. Objective of the Study: To develop and validate the instruments for measuring staff perception on Cost Containment Practices (CCP) and related factors in the hospital setting in the North Region in the Kingdom of Saudi Arabia. Methodology: The study instruments consist of 11 items measuring cost containment practice (CCP), 11 items measuring healthcare quality (HQ) and 8 items measuring staff attitude (SA) were newly constructed. Otherwise, the 17 items measuring health information technology (HIT) and another 17 items for measuring organization empowerment (OE) were adapted and modified from previous studies. All items were measured using the ten-point interval scale. The instrument was developed in stages: reviewing the literature and development of the item, experts’ verification for content validity, and face validity. Later, this study employed a cross-sectional design in two phases. In the pilot study stage, 170 respondents were sampled using a stratified random sampling method. The selected respondents were given an online self-administered questionnaire for data collection. Then, the researchers conducted exploratory factor analysis (EFA) to assess the usefulness of every item for measuring their respective construct. In the actual field study, another 247 respondents were sampled from two other hospitals to provide data for confirmatory factor analysis (CFA) to assess the instruments’ construct validity, convergent validity, and discriminant validity as well as its composite reliability. Results: The EFA results showed the extraction method of Principal Component with Varimax Rotation was significant. The Bartletts’ Test of Sphericity and the sampling adequacy by KMO test confirmed sufficiency of samples. None of the items were removed as all the items in all five constructs showed factor loading of more than 0.6. The reliability of all constructs was achieved by Cronbach’s Alpha above 0.8; CCP=0.805, HIT=0.890, OE=0.890, HQ=0.834 and SA=0.910. Furthermore, the CFA results for each construct fulfilled the construct validity through acceptable factor loadings (more than 0.6) and fitness indexes values achieved the threshold for all constructs and respective items. The fitness indexes were namely RMSEA, the Incremental Fit category; the CFI, the Parsimonious Fit category, and the ratio of Chisq/df. The study also revealed all Average Variance Extracted (AVE) and Composite Reliability (CR) results exceeded their threshold values of 0.5 and 0.6 respectively, which fulfilled the model Convergent Validity and Composite Reliability. In addition, the Discriminant Validity assessment ensured that no redundant constructs occur in the model and no multi-collinearity problem. Conclusion: The study produces a valid and reliable instrument for better assessment and understanding of practices on healthcare cost based on staff perception. It potentially reflects and explains the reasons behind the success or failure of cost containment initiatives. The present findings indicate applicability of the proposed instrument to measure cost containment practices in hospitals.