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Caught in organized ambivalence: institutional complexity and its implications in the German hospital sector

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  • Ingo Bode
  • Johannes Lange
  • Markus Märker

Abstract

Worldwide, public service-providing organizations confront regulatory hybridization. While their societal mission persists, they are expected to become more business-like. Drawing on theory concerned with institutional complexity and ambivalence in organizations, this article illuminates the case of German acute care hospitals. We depict the emergence of market orientation in this industry, its structural impact and major sensemaking patterns at the site level. In our multiple case study, we find ‘organized ambivalence’ shaping the institutional context and affecting the undertakings’ internal life. Thus, regulatory hybridization tends to create certain traps – which challenges ideas according to which it helps improve public management.

Suggested Citation

  • Ingo Bode & Johannes Lange & Markus Märker, 2017. "Caught in organized ambivalence: institutional complexity and its implications in the German hospital sector," Public Management Review, Taylor & Francis Journals, vol. 19(4), pages 501-517, April.
    • Handle: RePEc:taf:rpxmxx:v:19:y:2017:i:4:p:501-517
    DOI: 10.1080/14719037.2016.1195437
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    Cited by:

    1. Silvana Secinaro & Luigi Corvo & Valerio Brescia & Daniel Iannaci, 2019. "Hybrid Organizations: A Systematic Review of the Current Literature," International Business Research, Canadian Center of Science and Education, vol. 12(11), pages 1-21, November.
    2. Saka-Helmhout, Ayse, 2020. "Institutional agency by MNEs: A review and future research agenda," Journal of International Management, Elsevier, vol. 26(2).
    3. Victor Zitian Chen & John Cantwell, 2022. "An evolutionary view of institutional complexity," Journal of Evolutionary Economics, Springer, vol. 32(3), pages 1071-1090, July.
    4. Giliberto Capano & Benedetto Lepori, 2024. "Designing policies that could work: understanding the interaction between policy design spaces and organizational responses in public sector," Policy Sciences, Springer;Society of Policy Sciences, vol. 57(1), pages 53-82, March.

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