A multidimensional model of organizational legitimacy: Hospital survival in changing institutional environments

Using data on 143 hospital organizations, this article examines the anteced ents and effects of two forms of organizational legitimacy (managerial and technical) over a 46-year period. Results show that both the managerial and technical forms provide notable improvements in organizational survival ch ances but that the strength of each effect varies over time depending on th e nature of the institutional environment. Variation also appears in the an tecedents of legitimacy-for example, the ability of a hospital to secure ap proval for its managerial practices depends on the correspondence between i ts mission and the logic of the surrounding institutional environment. The results suggest that a multidimensional model can reveal nuances of organiz ational legitimacy that are missed by more unitary conceptions.(.)