Reasons for Bureaucracy in the Management of Portuguese Public Enterprise Hospitals – an Institutional Logics Perspective

There is widespread perception that bureaucracy is omnipresent in Portuguese health care management. This is despite bureaucracy being heavily deprecated. This paper addresses this dissonance by studying the Portuguese Public Enterprise Entity Hospitals context. It seeks to understand how a bureaucratic approach prevails. The study is based on document analysis and extends the Institutional Logics Perspective to the health care context. Three institutional logics were observed: State, community, and profession. The need to resolve conflicts between the different logics induces a neo-bureaucratic approach to management. This paper contributes by identifying the institutional drivers of bureaucratic logic in health care settings.