title: Hospital funding constraints: strategic and tactical decision responses to sustained moderate levels of crisis in six Canadian hospitals.
abstract: This article reports on a study to ascertain the strategic and tactical responses of policy decision-makers in six Ontario hospitals to moderate levels of 'underfunding' by the provincial government over a 5 year period. The study provides a preliminary test of several theoretical ideas in the current literature on organizational decline. Findings support the hypothesized importance of the decision-makers' subjective interpretation of the causes for cutbacks, and the common initial tendency to 'blame inward' and cut costs through efficiency measures. It also illustrates how prolonged underfunding can bring about a shift in response from one based on techno-economic rationality to political bargaining.
mesh_terms: D002170:Canada; D003657:Decision Making; D005376:Financial Management; D005377:Financial Management, Hospital; D005380:Financing, Government; D005653:Fund Raising; D006764:Hospitals, Community / Q000191:economics*; D009864:Ontario