Development and Evaluation of an Integrated Theoretical Model of Changes in the Organization of Medical Care

Award Year:
W. Richard Scott
Healthcare Organization
This study elaborates upon and empirically evaluates an integrated theoretical framework designed to depict and better account for changes in the organization of the U.S. medical care delivery system during the past three decades. It includes and synthesizes important developments in organization theory including contingency theory, resource dependence, population ecology, transaction costs economics, and institutional theory and illuminates fundamental changes that have occurred in medical care organizations since 1960. Major organization theories and existing empirical research on medical care organizations are evaluated. A data base on changes occurring in the medical services sector in the San Francisco Bay area from 1960 to 1995 are assembled and analyzed to support the testing of hypotheses drawn from a variety of theoretical perspectives.