Bolon D S
Ohio University, Athens, USA.
J Health Hum Serv Adm. 1998 Summer;21(1):70-9.
The health care industry is experiencing rapid change and uncertainty. Hospitals, in particular, are redesigning structures and processes in order to maximize efficiencies and remain economically viable. This article uses two organizational theory perspectives (bureaucracy and institutional theory) to examine many of the trends and transitions which are occurring throughout the hospital industry. It suggests that many of the key tenets of bureaucracy (rationality, efficiency, productivity, control, etc.) have been incorporated into the institutional environment as normative expectations. This synthesis or blending of these two perspectives is labeled institutionaucracy, implying that, as productivity and efficiency considerations become institutionalized, hospitals conforming to such operational standards will gain legitimacy and additional resources from their environment.
医疗保健行业正在经历快速变革和不确定性。特别是医院，正在重新设计结构和流程，以实现效率最大化并保持经济上的可行性。本文运用两种组织理论视角（官僚制和制度理论）来审视整个医院行业正在发生的许多趋势和转变。研究表明，官僚制的许多关键原则（合理性、效率、生产力、控制等）已作为规范性期望融入制度环境。这两种视角的这种综合或融合被称为“制度官僚制”，意味着随着对生产力和效率的考量被制度化，符合此类运营标准的医院将从其环境中获得合法性和额外资源。
