Hospital wage and administration patterns: A metropolitan Toronto case study.

Abstract

The existence of the well documented activities of the local voluntary hospital association in Metropolitan Toronto, Ontario, Canada, with respect to the matter of wage and salary administration patterns provided a unique opportunity to explore a number of integrated elements key to understanding the current wage patterns observed in the Metropolitan Toronto and area hospitals. The research itself utilized the records, reports, minutes, and the wage and salary database maintained by that association, the Hospital Council of Metropolitan Toronto (HCMT), from 1958 to 1988. An initial case study approach revealed that HCMT as an organization, exemplified a political system that utilized a rational tool (i.e., an innovative collective job evaluation exercise), to address its legitimate decision-making requirements. This finding gave evidence to the fact that the organization truly served the interest of its membership while at the same time supported the legitimate survival goals of the association. Individual hospital responses to the recommendations resulting from the job evaluation exercise were then examined from the perspective of organizational attributes. However the research failed to find any significant support for the research hypothesis that response to the collective innovative salary recommendation was positively related to the individual institution's degree of complexity, formalization, organizational slack, size, elite values and teaching affiliation. Finally, to assess the effectiveness of the Ontario legislative approach to pay equity, regression models were developed. The results indicated that the percentage female did have a significant impact on determining the level of compensation for lower ranked hospital based jobs. The policy implications of these findings included the fact that the study did not confirm any perception that a substantial number of female dominated hospital occupations were under compensated according to the principles of comparable worth. In addition, the Ontario pay equity legislation, as currently written, was found to be of limited future value to the sample hospital community.