Fusie versus samenwerking: interorganisationele besluitvorming in de ziekenhuiswereld

Samenvatting

The year 1967 signaled a new merger wave among Dutch general hospitals. Based on 10 merger case studies, it is argued that merger is not merely the evolutionary end of cooperation but frequently serves as a strategic alternative to it. It may be seen as an attempt to solve interorganizational problems in an intraorganizational way. Many of these problems can be seen in the context of government policy to control costs & quality of health care. The active proponents & opponents of merger plans are inspired by their professional bias toward large-scale organizations, & by personal benefit or damage expected of a potential merger. It is also important to study the power differential between hospitals, since it determines the power structure in a merged facility to a greater extent than might be inferred from public statements. A general study of interorganizational relations should include the structure of interests, transactions, & professional ideologies. A framework to explain the instability of cooperation, in contrast to merger, is derived from P. Blau's Exchange and Power in Social Life (New York: Wiley, 1964). 1 Table, 1 Figure. Modified HA.