How are employees at different levels affected by privatization? A longitudinal study of two Swedish hospitals

Despite the amount of privatizations around the world in recent decades, only limited research attention has been paid to how privatization affects the employees. The effects are likely to vary depending on the individual's position in the organization. The aim of this study was to investigate how employees' work‐related attitudes and strain changed after privatization of a Swedish acute care hospital, and to analyze whether the effects of privatization differed between employees at various hierarchic levels. Questionnaire data collected at a hospital 1 year before and 2 years after privatization, as well as at a hospital which remained a public administration unit, suggest only limited effects of privatization on a general level, but that employees at various hierarchic levels may be affected differently. While employees at a high level (physicians) and low level (assistant nurses) reported only marginal differences over time in work attitudes and strain, also in comparison with their colleagues at the comparison hospital, work attitudes of employees at the intermediate level (registered nurses) decreased after privatization. These results emphasize the importance of taking hierarchic level into account when a privatization is implemented and analyzed.