Table 2.

Direct and Indirect Effects Between Impact of PBR System on Quality of Care

Effect type	Relationship	Quality of individual care			Quality of organizational care
Effect type	Relationship	Effect^{^a}	95% CI	t	Effect^{^a}	95% CI	t
Direct effect	PBR ➞ QoC	−0.013	−0.091 to 0.066	−0.317	0.055	−0.039 to 0.149	1.144
Total effect	PBR ➞ QoC	0.062	−0.019 to 0.143	1.522	0.121	0.026 to 0.216	2.512
Indirect effect	PBR ➞ IWT ➞ MD ➞ QoC	0.011	0.004 to 0.021	…	0.006	−0.001 to 0.015	…
Indirect effect	PBR ➞ IWT ➞ QoC	0.075	0.041 to 0.112	…	0.046	0.019 to 0.077	…
Indirect effect	PBR ➞ MD ➞ QoC	0.027	0.001 to 0.049	…	0.015	−0.001 to 0.015	…

IWT = illegitimate work tasks; MD = moral distress; PBR = performance-based reimbursement; QoC = quality of care.
↵a Adjusted for age, gender, quantitative workload.