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Measuring work complexity for acute care services

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT 2021年第6期36卷 2199-2214页

作者： Lin, Shuguang Rouse, Paul Zhang, Fan Wang, Ying-Ming Fuzhou Univ Decis Sci Inst 2 Xueyuan Rd Fuzhou 350108 Peoples R China Univ Auckland Dept Accounting & Finance Auckland New Zealand Fujian Med Univ Affiliated Fuzhou Hosp 1 Fuzhou Peoples R China Yango Univ Sch Business Fuzhou Peoples R China

Case weights capture the resource cost by diagnosis-related group (DRG) but may not fully reflect the complexity of the clinical services provided. This study describes the use of a work complexity index (WCI), for assessing acute care services focusing on those provided by physicians in healthcare systems. The services are classified using relative value units (RVUs) and their point value assigned using the resource-based relative value scale. 57,559 acute inpatients from a tertiary hospital were first classified into diagnosis-related groups, which together with the relative value units assigned to services were then used to calculate a work complexity index for 38 departments. A case mix index (CMI) was also compiled as a conventional measure of complexity which had a correlation of 0.676 (p < 0.001) with the WCI. The correlation between the WCI and the RVUs representing the weighted volume of physician activities was 0.342 (p = 0.036). The WCI represents a more output or activity focused measure of complexity whereas the CMI is more patient focused and thus provides better insights into Departments' productivity. Although this paper focuses on physicians, the WCI can be easily extended to include other clinical services.

关键词： diagnosis-related group (DRG) productivity measurement resource-based relative value scale (RBRVS) work complexity

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Perceived Leader Regulatory-focused Modeling, work complexity,work Regulatory Focus and Job Crafting: A Mediated Moderation Model

Perceived Leader Regulatory-focused Modeling, Work Complexit...

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第17届创新与管理国际学术会议（ICIM2020）

作者： Ren Zheng School of Management Chengdu University of Information Technology School of Management University of Wales Trinity Saint David School of Management Xi'an Jiaotong University

Differing from traditional top-down work design, job crafting is the change of job characteristics made by subordinates themselves, highlighting the subordinates' initiation. Drawing on regulatory focus theory by data collected from 336 subordinates and their supervisors, this study examined a mediated moderation model for job crafting. The results showed that: work regulatory focus mediates the relationship between perceived leader regulatory-focused modeling and job crafting;work complexity moderates the relationship between perceived leader regulatory-focused modeling and job crafting;work regulatory focus mediates the moderating relationship among perceived leader regulatoryfocused modeling, work complexity and job crafting. The author discussed implications of these results for research and practice.

关键词： Job crafting Leadership work complexity Regulatory focus Role modeling

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work complexity and cognitive functioning at midlife: Cross-validating the Kohn–Schooler hypothesis in an American cohort

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Chinese Journal of Sociology 2017年第3期3卷 329-353页

作者： Hauser, Robert M Roan, Carol L Department of Sociology The University of Wisconsin-Madison United States

In an influential body of work extending across more than three decades and drawing on data from the United States, Poland, Japan and the Ukraine, Melvin Kohn, Carmi Schooler and their associates have found that cognitive capacities are affected by experiences on the job;specifically, that working at a complex job improves cognitive functioning. These findings anticipate and parallel research on the relationships among social integration, leisure-time activities and cognitive functioning among the elderly. This paper tests the Kohn–Schooler hypothesis using different measures, models and data. Specifically, we estimate models of the reciprocal influence of work complexity and cognitive functioning at ages 53 to 54 and 64 to 65 among women and men who graduated from Wisconsin high schools in 1957. Even when adolescent academic ability test scores and high school rank have been controlled, we find moderate effects of the complexity of work on abstract reasoning ability at ages 53 to 54 (in 1993). These effects are similar among women and men and are robust to reasonable assumptions about the unreliability of measurement of adolescent academic ability. However, there were no such effects, either in 1993 or in 2004, among individuals who were still working at ages 64 to 65. Thus, the full set of findings provides only limited support for the Kohn–Schooler hypothesis. © The Author(s) 2017.

关键词： Ability cognition Kohn-Schooler hypothesis life course midlife reciprocal influence self-direction social learning work complexity

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Effects of Preretirement work complexity and Postretirement Leisure Activity on Cognitive Aging

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JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES 2016年第5期71卷 849-856页

作者： Andel, Ross Finkel, Deborah Pedersen, Nancy L. Univ S Florida Tampa FL 33620 USA St Annes Univ Hosp Int Clin Res Ctr Brno Czech Republic Indiana Univ Southeast Dept Psychol New Albany IN USA Karolinska Inst Stockholm Sweden Univ Southern Calif Los Angeles CA USA

We examined the influence of postretirement leisure activity on longitudinal associations between work complexity in main lifetime occupation and trajectories of cognitive change before and after retirement. Information on complexity of work with data, people, and things, leisure activity participation in older adulthood, and four cognitive factors (verbal, spatial, memory, and speed) was available from 421 individuals in the longitudinal Swedish Adoption/Twin Study of Aging. Participants were followed for an average of 14.2 years SD = 7.1 years) and up to 23 years across eight cognitive assessments. Most of the sample (88.6%) completed at least three cognitive assessments. Results of growth curve analyses indicated that higher complexity of work with people significantly attenuated cognitive aging in verbal skills, memory, and speed of processing controlling for age, sex, and education. When leisure activity was added, greater cognitive and physical leisure activity was associated with reduced cognitive aging in verbal skills, speed of processing, and memory (for cognitive activity only). Engagement in cognitive or physical leisure activities in older adulthood may compensate for cognitive disadvantage potentially imposed by working in occupations that offer fewer cognitive challenges. These results may provide a platform to encourage leisure activity participation in those retiring from less complex occupations.

关键词： Cognitive aging Growth curve analysis Leisure activity Retirement work complexity

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complexity of work and Incident Cognitive Impairment in Puerto Rican Older Adults

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JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES 2019年第5期74卷 785-795页

作者： Andel, Ross Davila-Roman, Ana Luisa Grotz, Catherine Small, Brent J. Markides, Kyriakos S. Crowe, Michael Univ S Florida Sch Aging Studies MHC 1323 Tampa FL 33620 USA St Annes Univ Hosp Int Clin Res Ctr Brno Czech Republic Univ Puerto Rico Sch Publ Hlth San Juan PR 00936 USA Univ Liege Psychol Aging Unit Liege Belgium Univ Texas Med Branch Dept Prevent Med & Community Hlth Galveston TX 77555 USA Univ Alabama Birmingham Dept Psychol Birmingham AL 35294 USA

Objective: We investigated complexity of work in main occupation in relation to incident cognitive impairment in older Puerto Ricans. Method: A population-based sample of 1,673 adults age 60+ for the Puerto Rican Elderly: Health Conditions (PREHCO) study was used. Cognition was measured at baseline and 4 years later using the Mini-Mental Caban (MMC), with scoring 1.5 SD below the MMC score adjusted for age, education, gender, and reading ability comprising cognitive impairment. complexity scores were derived from the 1970 U.S. Census, 1977 and 2000 Dictionary of Occupational Titles, and 2001 O*Net. Results: Controlling for baseline age, gender, childhood economic hardship, adult money problems, depressive symptoms, and self-reported health, greater scores for most work complexity measures were associated with significantly lower risk of cognitive impairment (ps <.05), with significant odds ratios ranging between 0.74, reflecting 26% reduction in risk for every extra standard deviation of complexity, and 0.81. Controlling for education reduced these effects slightly but also reduced most associations to nonsignificant. The results were stronger for those with less childhood economic hardship or education (ps <.05). Discussion: complexity of work may reduce risk of cognitive impairment in Puerto Rican older adults, especially when combined with favorable childhood economic conditions and higher educational attainment.

关键词： Cognition Cognitive impairment Puerto Rico work complexity

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work and the public understanding of science

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PUBLIC UNDERSTANDING OF SCIENCE 2024年第3期33卷 353-369页

作者： Kunovich, Robert M. Univ Texas Arlington Arlington TX USA Univ Texas Arlington Dept Sociol & Anthropol Box 19599 Arlington TX 76019 USA

This study examines whether engaging in science work and work that is substantively complex (e.g. requiring independent thought and judgment) is related to interest in science, science knowledge, and confidence in the scientific community in the United States. It also examines whether the conditions of work mediate the relationship between education and these science-related outcomes. Occupation-level data from O*NET are merged with survey data from the General Social Survey. Results indicate that science work is related to interest in science and science knowledge and that work complexity is related to confidence in the scientific community. Results offer only limited evidence of mediation-science work mediates the relationship between educational attainment and science knowledge but not the relationships involving interest or confidence. In sum, results indicate that the conditions of work are associated with science attitudes, and that researchers should examine these connections in future research.

关键词： interest science knowledge science work trust work complexity

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Multifaceted Demands of work and Cognitive Functioning: Findings From the Health and Retirement Study

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JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES 2022年第2期77卷 351-361页

作者： Lee, Yeonjung Jane Gonzales, Ernest Andel, Ross Univ Hawaii Manoa Thompson Sch Social Work & Publ Hlth Dept Social Work 2430 Campus Rd Honolulu HI 96822 USA NYU Silver Sch Social Work New York NY 10003 USA Univ S Florida Sch Aging Studies Tampa FL 33620 USA Motol Univ Hosp Dept Neurol Prague Czech Republic Charles Univ Prague Prague Czech Republic St Annes Univ Hosp Int Clin Res Ctr Brno Czech Republic

Objectives The present study examines the associations between mental, social, and physical demands of work and cognitive functioning among older adults in the United States. Method Data from 3,176 respondents in the Health and Retirement Study were analyzed using growth curve modeling (2004-2014). The study investigated differences by gender, race, ethnicity, and education. Results Higher mental and social demands of work were associated with higher levels of initial cognitive functioning, but were not significantly associated with slower cognitive decline over time. Physical demands of work were negatively associated with initial cognitive functioning and were also marginally associated with a slower rate of decline in cognitive functioning going into older adulthood. In stratified analyses, results varied by sociodemographic characteristics. Discussion The results partially support the environmental complexity hypothesis and the productive aging framework in that higher mental and social demands and lower physical demands relate to better cognitive functioning at baseline, with the differences appearing stable throughout older adulthood. The stratified results shed light on addressing disparities in cognitive aging and work environments.

关键词： Cognition Employment and older workers Quantitative methods work complexity

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Antecedents to verbal reward salience

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Scandinavian Journal of Management 2025年第2期41卷

作者： Siverbo, Sven Karlstad Business School Karlstad University Karlstad SE-651 88 Sweden

The aim of this research is to examine when verbal rewards are salient among personnel in workplaces, with a specific interest in how this relates to the behavior of superior managers. The study investigates several antecedents to verbal reward salience using a cross-sectional survey (n = 483). The findings indicate that verbal rewards tend to be more salient for personnel when their manager frequently provides them, when rewards are accompanied by specific attributes, when they are performance-contingent, and when personnel find the rewards attractive. While the study does not provide information about causality, the results are largely consistent with a conceptual model suggesting that certain managerial practices could potentially be linked to personnel perceiving verbal rewards as incentives. A subgroup analysis suggests that managerial practices related to verbal rewards differ in their association with verbal reward salience between the private and public sectors. © 2025 The Authors

关键词： Incentive Praise Verbal reward salience Verbal rewards work complexity

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Nurse manager cognitive decision-making amidst stress and work complexity

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JOURNAL OF NURSING MANAGEMENT 2013年第1期21卷 17-30页

作者： Shirey, Maria R. Ebright, Patricia R. McDaniel, Anna M. Univ So Indiana Coll Nursing & Hlth Profess Evansville IN 47712 USA Indiana Univ Sch Nursing Ctr Res & Scholarship Indianapolis IN 46204 USA

Aim The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity. Background Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions. Methods This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expertnovice practice differences. Content analysis identified one major theme and three sub-themes. Results The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes. Conclusions Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes. Implications for Nursing Management Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity.

关键词： complexity science nurse manager cognitive decision-making nurse manager cognitive work stress and coping work complexity

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Early- to late-life environmental factors and late-life global cognition in septuagenarian and octogenarians: The SONIC study

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ACTA PSYCHOLOGICA 2023年 233卷 103844页

作者： Ishioka, Yoshiko Lily Masui, Yukie Nakagawa, Takeshi Ogawa, Madoka Inagaki, Hiroki Yasumoto, Saori Ikebe, Kazunori Kamide, Kei Arai, Yasumichi Ishizaki, Tatsuro Gondo, Yasuyuki OP Jindal Global Univ Sonipat Narela Rd Sonipat 131001 Haryana India Tokyo Metropolitan Inst Gerontol 35-2 Sakae choItabashi ku Tokyo 1730015 Japan Natl Ctr Geriatr & Gerontol 7-430 Morioka cho Obu City Aichi 4748511 Japan Osaka Univ Grad Sch Human Sci 1-2 Yamadaoka Suita Osaka 5650871 Japan Keio Univ Ctr Supercentenarian Med Res Sch Med 35 Shinanomachi Tokyo Tokyo 1608582 Japan Osaka Univ Grad Sch Dent Dept Prosthodont Gerodontol & Oral Rehabil 1-8 Yamadaoka Suita Osaka 5650871 Japan Osaka Univ Div Hlth Sci Grad Sch Med 1-7 Yamadaoka Suita Osaka 5650871 Japan

This study aimed to evaluate cognitively stimulating environments throughout life and to examine direct and indirect associations between these environments and late-life cognition. Early-life education, three domains of work complexity (data, people, and things) based on the longest-held occupation, and engagement in late-life leisure activities (LAs) were assessed. A structural equation model was developed using cross-sectional data of 1721 Japanese older adults in 70 +/- 1 and 80 +/- 1 years. The model confirmed significant direct effects of work complexity with data and late-life LAs on late-life cognitive performance. The associations of education and work complexity with late-life cognition were mediated through the subsequent environment(s). However, the total effects of work complexity with people and things on late-life cognition were insignificant. The findings suggest that cognitively stimulating activities in adulthood and beyond may lead to individual differences in late-life global cognition. In addition, antecedent complex environments might make subsequent life environments more cognitively stimulating. The results are discussed from the perspectives of cognitive plasticity and environmental complexity.

关键词： Cognitive function Cognitive plasticity Cognitive reserve Environmental complexity work complexity

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