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Transitions in the Hierarchy of Authority in Hospitals

Implications for the Role of the Chief Executive Officer

Bibliographic Data

ID2545016
AuthorsPeter A Weil (corresponding author), Leo Stam
Year1986
Volume27
Issue2
Pages179
Publication date1986-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJournal of Health and Social Behavior (JOURNAL)
Journal identifiersISSN: 0022-1465 • E-ISSN: 2150-6000
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.2307/2136315
PMID3734383
OpenAlexW2335203728
LanguageEN
References cited7

Hospitals are being transformed from a cottage industry in which each institution is relatively autonomous to a series of multihospital systems where a network of individual institutions are directed from corporate headquarters. The present paper examines the impact of adding a hierarchical level to the top of the hospital on the role of the hospital's chief executive officer (CEO). We report results of CEO functioning (201 from multihospital systems and 188 from traditionalfreestanding hospitals) relative to (1) division of labor, (2) needfor coordination, and (3) managerial autonomy. We show that multisystem CEOs' activities are more standardized, but not more specialized, than those of freestanding hospital CEOs; however, we show only moderate support for the increased involvement in coordination activities for those in multihospital systems. Finally, while CEOs in multihospital systems exhibit less actual autonomy in their roles as managers, they perceive themselves as having more autonomy than CEOs in freestanding hospitals. These findings are considered with respect to the administrator's credo of balancing the need of communities for healthcare with the organization's need to remain financially viable

Autonomy · Business · Chief executive officer · Control (management) · Economics · Hierarchy · Institution · Management · Officer · Political science · Public relations · Sociology · Healthcare Policy and Management · Healthcare Quality and Management · Patient Satisfaction in Healthcare · Psychology

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    W Richard Scott•Organizations•1987

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    Peter M Blau, W Richard Scott•Formal Organizations•1962

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    Georg Simmel•Conflict•1955

  • The Structure of Small Bureaucracies

    Peter M Blau, Wolf V Heydebrand et al.•American Sociological Review•1966

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    Joseph W Lella, Joseph Lella et al.•Social Forces•1975

  • The Hierarchy of Authority in Organizations

    Peter M Blau•American Journal of Sociology•1968

Citation velocityhistorical
Highly citedNo

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