Analyzing the mediating effect of perceived organizational support on feedback and role satisfaction: evidence from healthcare

The accountability of care approach has profoundly changed the responsibilities and the tasks assigned to physicians heading of Operational Units (OUs) within healthcare organizations, who have become “doctor-managers”. The hybridization of middle managers makes them particularly exposed to role ambiguities, causing adverse psychological reactions and, in turn, counterproductive behaviours and scarce managerial performance. This lead to seek greater convergences of the new managerial role of doctors heading of OUs with their predominant clinical professional culture. Adopting a psychology-based budgeting approach, the aim of this study was to shed a light on the role of budgetary performance feedback in avoiding such undesired outcomes. More in depth, this paper explores the influence of budgetary performance feedback on doctor-managers’ Perceived Organizational Support (POS) and the mediating role of this latter in the feedback-role satisfaction link. Empirical analyses were carried out in public hospitals of the Italian National Health Service. A linear regression model was performed to test the hypotheses. The study demonstrated that budgetary performance feedback positively influences both POS and budget holder role satisfaction and that POS fully mediates the link between doctor-managers’ feelings of budgetary performance feedback and their satisfaction with the budget holder role. Our results aim at increasing the knowledge in the accountability of care field. More in depth, the paper contributes to the scant psychology-based empirical research into the individual-level benefits of accounting information, adding evidence on the neglected role of the related perceptions in mitigating doctor-managers’ role ambiguity reactions and related adverse psychological outcomes.