Institutional Change and the Organization of Health Care

The Dynamics of "Muddling Through"

Published in: Handbook of Medical Sociology, Sixth Edition / Bird, Chloe E., Conrad, Peter, and Fremont, Allen M. (Nashville, TN: Vanderbilt University Press, 2010), Chapter 15, p. 249-269

Posted on RAND.org on January 01, 2010

by Peter Mendel, W. Richard Scott

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This chapter reflects important changes in the study of health care organizations, delivery, and impact. The authors portray changes in the organization of U.S. Health care from the 1940s through the 1990s. Their review establishes a foundation for understanding recent health care turmoil, and makes a case that what may appear to be institutional disarray may instead reflect innovation in models of organization and strategies to reconcile competing actors, logics, and structures from earlier eras.

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