title: Downsizing in the public sector: Metro-Toronto's hospitals.
abstract: This study has two objectives. First, to predict the outcomes of a public sector downsizing; second to measure effects of downsizing at organizational and inter-organizational levels. Primary data to assess the organizational level effects was collected through interviews with senior executives at two of Metro-Toronto's hospitals. Secondary data, to assess the inter-organizational effects, was collected from government documents and media reports. Due to the exploratory nature of the study's objectives a case study method was employed. Most institutional downsizing practices aligned with successful outcomes. Procedures involved at the inter-organizational level aligned with unsuccessful outcomes and negated organizational initiatives. This resulted in an overall alignment with unsuccessful procedures. The implication, based on private sector downsizings, is that the post-downsized hospital system was more costly and less effective.
authors.affiliation: Faculty of Administration, University of New Brunswick, Fredericton, Canada.
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Flint
mesh_terms: D006302:Health Services Research; D006740:Hospital Administrators / Q000523:psychology; D006754:Hospital Restructuring / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration; D006786:Hospitals, Urban / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D009864:Ontario; D017063:Outcome Assessment, Health Care / Q000592:standards; D020415:Personnel Downsizing / Q000379:methods* / Q000458:organization & administration; D017149:Private Sector; D017150:Public Sector; D011795:Surveys and Questionnaires; D000078329:Workforce; D016526:Workload / Q000191:economics