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Using data on 143 hospital organizations, this article examines the antecedents 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 chances but that the strength of each effect varies over time depending on the nature of the institutional environment. Variation also appears in the antecedents of legitimacy-for example, the ability of a hospital to secure approval for its managerial practices depends on the correspondence between its mission and the logic of the surrounding institutional environment. The results suggest that a multidimensional model can reveal nuances of organizational legitimacy that are missed by more unitary conceptions.
Max Weber was among the first great social theorists to stress the importance of legitimacy. In his definitional foundations of the types of social action, he gave particular attention to those forms of action that were guided by a belief in the existence of a legitimate order: a set of "determinable maxims," a model regarded by the actor as "in some way obligatory or exemplary for him" (Weber, 1968: 31). In his own work, Weber applied the concept to the legitimation of power structures, both corporate and governmental. His widely rehearsed typology of administrative systems depends on whether the subordinate actor regards the order as binding because of its traditional nature, the charismatic qualities of its leader, or because it has been legally constituted. Variations in such beliefs have been shown to have implications for the structure, stability, and operations of the system, and this work spawned a large number of empirical studies of different types of power and authority systems (e.g., French and Raven, 1959; Dornbusch and Scott, 1975; Kelman and Hamilton, 1989). While analyzing legal order, Weber (1968: 313) developed a distinction between general social norms and what he termed guaranteed law: the existence of a "coercive apparatus, that is, that there are one or more persons whose special task it is to hold themselves ready to apply specially provided means of coercion (legal coercion) for the purpose of norm enforcement." Thus, Weber regarded regulatory institutions as clearly distinctive from other, normative elements.
In proposing his cultural-institutional perspective, Parsons (1960) broadened the focus of legitimation to...