Hospital funding constraints: Strategic and tactical decision responses to sustained moderate levels of crisis in six Canadian hospitals

V. V. Murray, T. D. Jick and P. Bradshaw

Social Science & Medicine, 1984, vol. 18, issue 3, 211-219

Abstract: This article reports on a study to ascertain the strategic and tactical responses of policy decision-makers in six Ontario hospitals to moderate levels of 'underfunding' by the provincial government over a 5 year period. The study provides a preliminary test of several theoretical ideas in the current literature on organizational decline. Findings support the hypothesized importance of the decision-makers' subjective interpretation of the causes for cutbacks, and the common initial tendency to 'blame inward' and cut costs through efficiency measures. It also illustrates how prolonged underfunding can bring about a shift in response from one based on techno-economic rationality to political bargaining.

Date: 1984
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