Background
Literature review
Medical team strategy on OHCs and related theories
The upper echelons theory
Professional capital and related theories
The social exchange theory
Team heterogeneity and its impact on team outcomes
Research model and hypotheses
Professional capital and TSD
Team heterogeneity and TSD
Methods
Research context
Sample and data collection
Measures of variables and empirical models
Dependent variable
Independent variables
Variables | Description/Explanation | Type | Mean | Std. | Min. | Max. |
---|---|---|---|---|---|---|
Dependent variables | ||||||
Team-based service demands (TSD) | The average number of team-based service demands the MT received during the two time periods. | Interval | 1.958 | 4.6803 | 0 | 69 |
Independent variables | ||||||
Layer 1: Team Leader | ||||||
Decisional Capital (DCL) | ||||||
Recommendation (Rec) | Comprehensive recommended heat for the doctor, evaluated by patients. | Interval | 4.144 | 0.382 | 3 | 5 |
Quantity of one-to-one service (Qoos) | The total number of one-to-one services that the doctor offers. | Interval | 36.94 | 169.75 | 0 | 3166 |
Status Capital (SCL) | ||||||
Doctor’s Clinic Title (CTitle) | When clinic title of the lead doctor is Chief Doctor or Associate Chief Doctor, the value of CTitle is 1; otherwise, it is 0. | Dummy | – | – | 0 | 4 |
Doctor’s Academic Title (ATitle) | When the academic title of the lead doctor is Professor or Associate Professor, the value of ATitle is 1; otherwise, it is 0. | Dummy | – | – | 0 | 4 |
Hospital Level (HL) | Hospital level is evaluated and issued by government health departments. When hospital level is level 3, being the best, the value of HL is 1; otherwise, it is 0. | Dummy | – | – | 0 | 3 |
City Level (CL) | When the team leader is in developed cities (Beijing/Shanghai/Guangdong), the value of CL is 1; otherwise, it is 0. | Dummy | – | – | 1 | 4 |
Layer 2: MTs | ||||||
Decisional Capital (DCT) | ||||||
Rec of Team | Sum of recommendation of all members. | Interval | 17.02 | 11.27 | 0 | 99 |
Qoos of Team | Sum of one-to-one service demands of all members. | Interval | 49.82 | 182.05 | 0 | 3178 |
Patient Quantity (PQ) | The number of patients that the MT had at the beginning of this study. | Interval | 13.99 | 25.273 | 0 | 640 |
Status Capital (SCT) | ||||||
Quantity with High Title Doctors (DQHT) | The number of doctors with clinic title of Chief Doctor or Associate Chief Doctor in the MT. | Interval | 2.226 | 2.292 | 0 | 23 |
Quantity of Level3 Hospitals (HQL) | The number of doctors in Level3 hospital in the MT. | Interval | 1.294 | 1.084 | 0 | 11 |
Quantity in Developed Cities (DQDC) | The number of doctors in developed cities in the MT. | Interval | 2.06 | 2.876 | 0 | 24 |
Team Heterogeneity (TH) | ||||||
The quantity of Members (Qmem) | The number of member doctors in the MT. | Interval | 4.488 | 2.900 | 2 | 24 |
Blau Index of Titles (Blautit) | Heterogeneity of member titles in the MT. | Interval | 0.490 | 0.187 | 0 | 0.8 |
The quantity of Titles (Qtit) | The number of title types in the MT. | Interval | 2.46 | 0.799 | 1 | 5 |
Control variables (Service Process) | ||||||
Response speed (RS) | Response speed of the MT for team-based written consultation. | Interval | 0.433 | 0.436 | 0 | 1 |
Price (P) | Price offered by the MT for team-based written consultation. | Interval | 73.62 | 83.56 | 0 | 800 |
Control variables
Results
Descriptive statistics and correlations
Variables | (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | (10) | (11) | (12) | (13) | (14) | (15) | (16) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(1) Rec | ||||||||||||||||
(2) Qoos | 0.239a | |||||||||||||||
(3) CTitle | 0.087a | 0.102a | ||||||||||||||
(4) ATitle | 0.200a | 0.032 | 0.463a | |||||||||||||
(5) HL | 0.140a | −0.005 | 0.049 | 0.072b | ||||||||||||
(6) CL | 0.282a | 0.142a | 0.092a | 0.023 | −0.014 | |||||||||||
(7) Rec of Team | 0.155a | 0.038 | 0.203a | 0.126a | 0.026 | 0.057 | ||||||||||
(8) Qoos of Team | 0.225a | 0.894a | 0.103a | 0.000 | −0.024 | 0.153a | 0.157a | |||||||||
(9) PQ | 0.327a | 0.570a | 0.076b | 0.021 | 0.013 | 0.128a | 0.138a | 0.585a | ||||||||
(10) DQHT | 0.058 | 0.033 | 0.335a | 0.186a | 0.021 | 0.038 | 0.714a | 0.122a | 0.049 | |||||||
(11) HQL | 0.094a | 0.021 | 0.031 | 0.047 | 0.104a | 0.071b | 0.349a | 0.048 | 0.073b | 0.434a | ||||||
(12) DQDC | 0.248a | 0.113a | 0.187a | 0.162a | 0.014 | 0.563a | 0.505a | 0.195a | 0.154a | 0.347a | 0.195a | |||||
(13) Qmem | 0.100a | 0.044 | 0.214a | 0.120a | 0.014 | 0.035 | 0.943a | 0.131a | 0.100a | 0.756a | 0.350a | 0.450a | ||||
(14) Blautit | 0.046 | 0.071b | 0.423a | 0.218a | −0.021 | 0.098a | 0.251a | 0.084b | 0.094a | 0.130a | 0.012 | 0.164a | 0.262a | |||
(15) Qtit | 0.109a | 0.080b | 0.428a | 0.209a | −0.006 | 0.103a | 0.511a | 0.113a | 0.128a | 0.260a | 0.078b | 0.328a | 0.518a | 0.847a | ||
(16) RS | 0.338a | 0.101a | 0.052 | 0.036 | 0.069b | 0.105a | 0.112a | 0.149a | 0.255a | 0.024 | 0.050 | 0.095a | 0.058 | 0.026 | 0.045 | |
(17) P | 0.303a | 0.120a | 0.091b | 0.097a | 0.028 | 0.204a | 0.134a | 0.160a | 0.013 | 0.109a | 0.020 | 0.231a | 0.091a | 0.059 | 0.072b | −0.007 |
Empirical results
Variables | Decisional Capital | Status Capital | ||
---|---|---|---|---|
Coefficient | Standard coefficient | Coefficient | Standard coefficient | |
Intercept | −0.240 | − 2.767*** | ||
CTitle
| 0.507*** | 0.107 | 1.130*** | 0.120 |
ATitle
| −0.137 | −0.044 | 1.139*** | 0.185 |
HL
| −0.143 | −0.037 | 0.421* | 0.055 |
CL
| −0.016 | −0.005 | 1.522*** | 0.253 |
DCL
| 0.536*** | 0.554 | 0.084 | 0.044 |
R2 | 0.311 | 0.162 | ||
Adjusted R2 | 0.307 | 0.157 | ||
F | 79.754*** | 34.092*** |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |||||
---|---|---|---|---|---|---|---|---|---|---|
coefficient | Standard coefficient | Coefficient | Standard coefficient | Coefficient | Standard coefficient | Coefficient | Standard coefficient | Coefficient | Standard coefficient | |
Intercept | 1.387*** | 1.229*** | 1.197*** | 0.972*** | 0.832*** | |||||
Control variables | ||||||||||
Response speed (RS) | 4.134*** | 0.553 | 3.334*** | 0.446 | 3.198*** | 0.428 | 3.187*** | 0.427 | 3.215*** | 0.430 |
Price (P) | −0.003** | − 0.065 | − 0.007*** | − 0.178 | − 0.006*** | − 0.157 | − 0.006*** | −0.156 | − 0.006*** | − 0.154 |
Team leader | ||||||||||
DCL
| 0.727*** | 0.351 | 0.246*** | 0.119 | 0.190** | 0.092 | 0.178** | 0.086 | ||
SCL
| 0.296*** | 0.090 | 0.435*** | 0.132 | 0.480*** | 0.146 | 0.524*** | 0.159 | ||
MT | ||||||||||
DCT
| 0.551*** | 0.369 | 0.616*** | 0.412 | 0.605*** | 0.405 | ||||
SCT
| −0.053*** | −0.096 | −0.038** | −0.069 | −0.045* | −0.082 | ||||
TH
| −0.181*** | − 0.088 | − 0.458*** | −0.223 | ||||||
TH*DCL
| 0.091** | 0.065 | ||||||||
TH*SCL
| 0.133** | 0.180 | ||||||||
TH*DCT
| −0.008 | −0.012 | ||||||||
TH*SCT
| −0.005 | −0.036 | ||||||||
R2 | 0.311 | 0.436 | 0.496 | 0.501 | 0.509 | |||||
Adjusted R2 | 0.309 | 0.433 | 0.493 | 0.498 | 0.503 | |||||
F | 200.208 | 170.868 | 144.928 | 126.386 | 82.817 | |||||
ΔR2 | 0.311 | 0.125 | 0.60 | 0.005 | 0.008 | |||||
ΔF | 200.208 | 97.821 | 52.938 | 8.121 | 3.781 |
The effect of team heterogeneity
Robustness test
Variables | Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |||||
---|---|---|---|---|---|---|---|---|---|---|
Coefficient | Standard coefficient | Coefficient | Standard coefficient | Coefficient | Standard coefficient | Coefficient | Standard coefficient | Coefficient | Standard coefficient | |
Intercept | 1.387*** | 1.229*** | 1.197*** | 0.963*** | 0.785*** | |||||
Control variables | ||||||||||
Response speed (RS) | 4.134*** | 0.553 | 3.334*** | 0.446 | 3.198*** | 0.428 | 3.184*** | 0.426 | 3.190*** | 0.427 |
Price (P) | −0.003** | − 0.065 | − 0.007*** | − 0.178 | − 0.006*** | − 0.157 | − 0.006*** | − 0.156 | − 0.006*** | − 0.155 |
Team leader | ||||||||||
DCL | 0.727*** | 0.351 | 0.246*** | 0.119 | 0.181** | 0.088 | 0.176** | 0.085 | ||
SCL | 0.296*** | 0.090 | 0.435*** | 0.132 | 0.466*** | 0.142 | 0.505*** | 0.154 | ||
MT | ||||||||||
DCT | 0.551*** | 0.369 | 0.632*** | 0.423 | 0.620*** | 0.415 | ||||
SCT | −0.053*** | − 0.096 | − 0.031 | − 0.055 | − 0.029* | − 0.053 | ||||
TH
| −0.203*** | −0.108 | − 0.445*** | −0.238 | ||||||
TH*DCL | 0.061** | 0.055 | ||||||||
TH*SCL | 0.106** | 0.168 | ||||||||
TH*DCT | −0.008 | −0.072 | ||||||||
TH*SCT | −0.017 | − 0.032 | ||||||||
R2 | 0.311 | 0.436 | 0.496 | 0.502 | 0.511 | |||||
Adjusted R2 | 0.309 | 0.433 | 0.493 | 0.498 | 0.505 | |||||
F | 200.208 | 170.868 | 144.928 | 127.239 | 83.296 | |||||
ΔR2 | 0.311 | 0.125 | 0.60 | 0.006 | 0.008 | |||||
ΔF | 200.208 | 97.821 | 52.938 | 11.128 | 3.684 |
Discussion
Result analysis
Hypotheses | Results |
---|---|
H1a. CCL(+)➔CCT | Supported |
H1b. SCL(+)➔CCT | Supported |
H1c. CCL(+)➔SCT | Supported |
H1d. SCL(+)➔SCT | Supported |
H2a. CCL(+)➔TSD of MTs | Supported |
H2b. SCL(+)➔TSD of MTs | Supported |
H3a. CCT(+)➔TSD of MTs | Supported |
H3b. SCT(+)➔TSD of MTs | Not supported/significant |
H4. TH(−)➔TSD of MTs | Supported |
H5a. CCL×TH(+)➔TSD of MTs | Supported |
H5b. SCL×TH (+)➔TSD of MTs | Supported |
H6a. CCT×TH (+)➔TSD of MTs | Not supported/significant |
H6b. SCT×TH (+)➔TSD of MTs | Not supported/significant |