Institutional change and healthcare organizations: from professional dominance to managed care

By D. Light. International Journal of Integrated Care, 2002

947 citations recorded by the source corpus.

From an historical and sociological perspective, ‘integrated care’ has emerged as part of institutional efforts to break up professional fiefdoms, especially of subspecialists entrenched in hospitals, and to reorganise services around clinically integrated pathways and services for the patients. It was the more enlightened part of what I have called the ‘buyers’ revolt’, which occurred in the 1980s when those who had long paid the bills (insurers, governments, employers) became so fed up by the waste, excesses, and variability of services delivered under professional dominance that they started to take forceful action w1x. This book is a masterpiece of historical work and organisational analysis of that revolt at its centre, the San Francisco Bay area.

Subfields: Economics and Econometrics, General Health Professions

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Citations in the corpus

What's on the path? Path dependence, organizational diversity and the problem of institutional change in the US economy, 1900-1950 (2007, background): “Some among the institutionally minded have analysed national capitalisms as organized around multiple, competing industrial orders or unanticipated, hybrid combinations of institutional elements (Herrigel, 1996; Stark, 1996; Heimer, 1999; Stryker, 2000; Scott et al., 2000; Campbell and Pederson, 200”
Having your cake and eating it too: discourses of transcendence and their role in organizational change dynamics (2011, background): “…accommodate the objectives of aesthetic quality and commercial success (Glynn, 2000; Thornton et al., 2005), while organizations in the health care field are traversed by competing pressures for quality, accessibility and efficiency (Scott et al., 2000; Denis et al., 2001; Reay and Hinings, 2005).”
Institutional Logics and Institutional Pluralism: The Contestation of Care and Science Logics in Medical Education, 1967–2005 (2010, background): “The profession of medicine has experienced both profound changes (e.g., Abbott, 1988; Scott et al., 2000; Reay and Hinings, 2005) and stability, allowing us to gain insight into how a profession’s logics and their relationships evolve over time.”
Forage for Thought: Mobilizing Codes in the Movement for Grass-fed Meat and Dairy Products (2008, positive): “Institutional theorists have conceived of market creation as an instance of institutional change within larger fields, often in the course of changing comprehensive institutional logics and field frames (Thornton and Ocasio, 1999; Scott et al., 2000; Thornton, 2004).”
Challenges to implementing artificial intelligence in healthcare: a qualitative interview study with healthcare leaders in Sweden (2022, background): “However, AI implementation represents a more substantial and more disruptive form of change than typically involved in implementing new practices in healthcare [60].”
A Social Movement Perspective on Finance: How Socially Responsible Investment Mattered (2010, methodology): “Although the field analytic method is widely used in field studies (Scott et al., 2000; Lounsbury et al., 2003), it suffers from several limitations.”
Sustaining Inter-organizational Relationships Across Institutional Logics and Power Asymmetries: The Case of Fair Trade (2016, background): “First, a well-established stream of research suggests that dominant institutional logics act as powerful normative forces that drive conformity—or isomorphism—within fields and at the organizational level (DiMaggio and Powell 1983; Kitchener 2002; Scott et al. 2000).”
Economic Activity and Institutions: Taking Stock (2005, background): “Third, at the macro, societal level changes in institutional logics (e.g., focus on effectiveness versus efficiency or vice versa) as well as associated changes in governance systems, have been found to affect the types and relative numbers of certain types of organization (Scott et al. 2000).”
The Role of Nonsystem Actors in the Relationship Between Policy and Practice: The Case of Reading Instruction in California (2005, background): “As discussed earlier, previous research has documented the way in which policy emerges from and is affected by interaction with nonsystem actors such as professional organizations, university researchers, policy entrepreneurs, and others (Hill, 2000; Kingdon, 1984; Laumann & Knoke, 1987; Moore, 1988”
Vive La Resistance: Competing Logics and the Consolidation of U.S. Community Banking (2007, background): “As institutional theorists have documented, professional identity is a significant driver of action, especially when autonomy is challenged, whether within organizations (e.g., Powell, 1985) or over an entire field or industry (e.g., Scott et al., 2000).”