Occupational health purchasing behaviour by SMEs – testing a new theoretical model

Introduction
It is widely recognised that occupational health provision is poor for smaller enterprises. Access to occupational health support would not be improved unless employers, especially those in small businesses, were motivated to seek such support. What is not clear is what influences the decisions made with regard to the purchase of occupational health. This paper presents a theoretical model describing purchasing decision makers based on a literature review. The model has been tested using a market research survey.

Methods
Peer-reviewed and grey literature was used to formulate the theoretical model. A cross-sectional survey utilising quantitative and qualitative research methods was carried out in 2007. A representative sample of enterprises employing 30 - 250 workers in all industrial sectors in five geographical locations in England was chosen to achieve 95% confidence intervals. Computer-assisted telephone interviewing of senior company employees were performed. A binary logistic was used to identify factors determing the purchase of services.

Results
Our model describes four organisation types based on knowledge of occupational health and awareness of occupational health benefits. The categories are Professional, Well-meaning amateur, Blinkered business analyst and Head in the sand. 387 enterprises took part in the market research. 24.3% had purchased occupational health. 76.5% understood occupational health. 35.4% rated occupational health very important. Three factors were identified to significantly effect the purchase of services: knowledge of occupational health, size of organisation and business triggers.

Discussion
The finding of a size effect is consistent with other studies. This stood out as a predictor of purchasing. Larger organisations would be more likely to be professional and aware of occupational health and of the business benefits. Absence from work due to illness maybe a trigger to reactive purchasing by blinkered analysts or head in the sand organisations. More research will be required to fully test out this theoretical model.