A Causal Model of Hospital Structure

Abstract

This article investigates whether hospital organizations evidence similar structural characteristics as do more traditional bureaucratic organizations. A causal model of organizational structure was ap plied to a sample of hospitals. Estimates of the causal model were used to access the similarity between structural arrangements within hos pitals and those reported for nonprofessional organizations. Results indicate that theoretical models of organizational structure are rele vant to professional organizations. Hospitals resemble more tradi tional bureaucratic organizations in that larger size and more specialization create more reliance upon formalization and automa tion as impersonal mechanisms of control. However, it is suggested that formalization may not be incompatible with professionalism, and that the use of professional standards and rules represents an ex tension of professionalization within the hospital and serves to elimi nate the need for personal supervision and control.