Título:	How professional and market logics and the conflict between institutional demands affect hospital accreditation compliance: a multiple-case study in Brazil
Autor(es):	Silva, Tiago Martins Ramos da Rossoni, Luciano
ORCID:	https://orcid.org/0000-0003-1104-8715 https://orcid.org/0000-0003-2289-0879
Afiliação do autor:	University of Grande Rio, Graduate Program in Administration, Brazil Oswaldo Cruz Foundation, Fernandes Figueira Institute, Rio de Janeiro, Brazil University of Brasília, Graduate Program in Administration
Assunto:	Hospitais Gestão hospitalar Saúde
Data de publicação:	27-Abr-2024
Editora:	MDPI AG
Referência:	SILVA, Tiago Martins Ramos da; ROSSONI, Luciano. How professional and market logics and the conflict between institutional demands affect hospital accreditation compliance : a multiple-case study in Brazil. Healthcare, [S. l.], v. 12, n. 9, p. 914, 2024. DOI: https://doi.org/10.3390/healthcare12090914. Disponível em: https://www.mdpi.com/2227-9032/12/9/914. Acesso em: 25 jun. 2026.
Abstract:	Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals’ management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate how professional and market logic, alongside conflicts arising from institutional demands, affect compliance with hospital accreditation. To this end, we conducted a multiple-case study in four Brazilian hospitals employing in-depth interviews and on-site observations. The triangulation of narrative analysis and the outcomes of multiple correspondence analysis revealed that when professional logic predominates, there is a greater propensity to tailor accredited activities by segmenting the tasks between physicians and nurses with the intention of mitigating existing conflicts. Conversely, when conflicts occur over established goals between professionals and orientated marked logic executives, the accreditation process is impeded, resulting in non-compliance. Ultimately, the findings underscore the alignment between the pursuit of legitimacy and efficiency within the accreditation process. We conclude by delineating the theoretical and practical implications of scrutinizing the internal dynamics of institutional logic.
Unidade Acadêmica:	Faculdade de Economia, Administração, Contabilidade e Gestão de Políticas Públicas (FACE) Departamento de Administração (FACE ADM)
Programa de pós-graduação:	Programa de Pós-Graduação em Administração
Licença:	Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
DOI:	https://doi.org/10.3390/healthcare12090914
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