A Multidimensional Model of Organizational Legitimacy: Hospital Survival in Changing Institutional Environments

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Using data on 143 hospital organizations, this article examines the antecedents and effects of two forms of organizational legitimacy (managerial and technical) over a 46-year period. Results show that both the managerial and technical forms provide notable improvements in organizational survival chances but that the strength of each effect varies over time depending on the nature of the institutional environment. Variation also appears in the antecedents of legitimacy - for example, the ability of a hospital to secure approval for its managerial practices depends on the correspondence between its mission and the logic of the surrounding institutional environment. The results suggest that a multidimensional model can reveal nuances of organizational legitimacy that are missed by more unitary conceptions.•.





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Ruef, M, and WR Scott (1998). A Multidimensional Model of Organizational Legitimacy: Hospital Survival in Changing Institutional Environments. Administrative Science Quarterly, 43(4). pp. 877–904. 10.2307/2393619 Retrieved from https://hdl.handle.net/10161/26624.

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Martin Ruef

Jack and Pamela Egan Distinguished Professor of Entrepreneurship

My research considers the social context of entrepreneurship from both a contemporary and historical perspective. I draw on large-scale surveys of entrepreneurs in the United States to explore processes of team formation, innovation, exchange, and boundary maintenance in nascent business startups. My historical analyses address entrepreneurial activity and constraint during periods of profound institutional change. This work has considered a diverse range of sectors, including the organizational transformation of Southern agriculture and industry after the Civil War, African American entrepreneurship under Jim Crow, the transition of the U.S. healthcare system from professional monopoly to managed care, and the character of entrepreneurship during early mercantile and industrial capitalism.

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