Just how integrated are integrated delivery systems? Results from a national survey

This article examines three emergent processes in physician-hospital integr ated delivery systems (IDSs). We find these processes ave underdeveloped ba sed on data gathered from a national sample of hospitals drawn from nine he alth cave systems. These processes ave also loosely coupled with the struct ures used to integrate physicians and hospitals, as well as with the Enviro nmental context in which they occur Such loose coupling entails both advant ages and disadvantages for IDSs.