Rhetorics of Efficiency, Fashion and Politics Hospital Mergers in Quebec
Bibliographic record
Abstract
Abstract Drawing on a content analysis of discourse surrounding five sequential hospital merger decisions, this research examines the role of efficiency considerations, fashion and politics in stimulating the adoption of a managerial idea. The article analyses how different arguments come to be intertwined. It illustrates how rational and institutional arguments are used to legitimate political strategies while simultaneously constituting the apparatus of legitimation for others in a reciprocal process that contributes to the persistence of those same strategies. The article thus confirms the key role of politics, interests and agency in the evolution and constitution of institutions, and in the diffusion of managerial ideas. Key Words: discourse analysis; hospital mergers; institutionalism; managerial ideas; politics Efficiency, fashion and politics represent three potential explanations for the adoption of organizational innovations (Tolbert and Zucker, 1996). The explana-tion with the longest tradition is the efficient choice or ‘rational ’ perspective, which assumes that adopters make independent and technically efficient choices based on calculations of costs and benefits (Rogers, 1983). In sharp contrast to this
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.012 | 0.011 |
| Scholarly communication | 0.007 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".