Eakin J M
Int J Health Serv. 1984;14(3):397-412. doi: 10.2190/U545-H8XN-HAKN-8ATB.
In 1973 the Canadian Province of Quebec "democratized" its hospital boards of directors by replacing their traditional lay community or religious members with individuals more representative of the hospitals' major interest groups. In the province's English-speaking hospitals, patients, community organizations, physicians and nonprofessional hospital employees elected representatives to boards that were formerly comprised mostly of business executives. After a brief description of the social organization of the former "elite" boards and their role in the distribution of power within hospitals, the paper demonstrates how the "elite" board members and hospital administrators retained control despite "democratization." Several theoretical explanations for this outcome are critically examined in the light of these empirical findings. One suggestion is that the "elite" administration survived democratization because it was "fitter" in terms of ability to influence the hospitals' major economic and political constraints.
1973年，加拿大魁北克省对其医院董事会进行了“民主化”改革，用更能代表医院主要利益集团的人员取代了传统的外行社区成员或宗教成员。在该省讲英语的医院中，患者、社区组织、医生和非专业医院员工选举代表进入董事会，而此前董事会成员大多是企业高管。在简要描述了以前“精英”董事会的社会组织及其在医院权力分配中的作用之后，本文展示了尽管进行了“民主化”，“精英”董事会成员和医院管理人员是如何保持控制权的。根据这些实证研究结果，对这一结果的几种理论解释进行了批判性审视。一种观点认为，“精英”管理层在民主化进程中得以存续，是因为就影响医院主要经济和政治限制因素的能力而言，它更“适应”。
