Domain Consensus in Alabama Health Systems Agencies

Abstract

The literature on organization behavior suggests four types of influences on domain consensus of organizations: (1) organizational design, (2) routine patterns of technical interorganizational contacts, (3) persuasive efforts by organizational leaders, and (4) organizational environment. In this study, conducted prior to the phase-out of health systems agencies (HSAs) in Alabama by the governor, responses from questionnaires to administrators of HSAs and hospitals in the state were used to compute a measure of HSA domain consensus. This measure served as the dependent variable in a regression analysis, with measures of the four types of influences as independent variables. The analysis suggests that one major influence on domain consensus was persuasion by HSA officials, particularly subtle, long-term efforts; a second major influence was organizational environment, specifically the experience and training of hospital administrators interacting with HSAs.