The effects of hospital characteristics and radical organizational change on the relative standing of health care professions.
This paper examines the effects of hospital characteristics and radical organizational change on the relative representation of health care professions in hospitals over the period of the 1980s.
Health care organizations, and hospitals in particular, represent organizations where multiple professional groups make competing claims of expertise that often conflict.
The question our research seeks to answer is whether different constellations of organizational characteristics and organizational changes affect the outcome of these professional conflicts.
Using the annual census of hospitals compiled by the American Hospital Association, we examine the effects of several characteristics of community hospitals on the relative representation of specific professional groups.
We find that hospital mergers favor physicians at the expense of administrators, and multihospital system affiliation favors technical core occupations at the expense of administrators.
Measures of organizational growth and decline increase the relative representation of physicians and administrators compared to nurses, and increase the probability that hospitals will employ physicians'assistants and nurse practitioners.
Our results are evaluated in light of recent developments in the sociology of medicine and research on the relative standing of occupations in other industries.
Mots-clés Pascal : Hôpital général, Organisation hospitalière, Gestion personnel, Médecin, Infirmier, Gestion administrative, Système santé, Politique sanitaire, Personnel sanitaire, Profession, Etats Unis, Homme, Structure personnel, Amérique du Nord, Amérique
Mots-clés Pascal anglais : General hospital, Hospital organization, Staff management, Physician, Nurse, Administrative management, Health system, Health policy, Health staff, Profession, United States, Human, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0381326
Code Inist : 002B30A05. Création : 01/03/1996.