When Institutions Collide: The Competing Forces of Hospitals Sponsored by the Roman Catholic Church

Abstract: For centuries, the Catholic Church has been a major social actor in the provision of health services, particularly health care delivered in hospitals. Through a confluence of powerful environmental forces at the beginning of the twenty-first century, the future of Catholic health care is threatened. Although United States Catholic hospitals are a separate case of private, nonprofit hospitals, they have experienced environmental pressures to compete with other hospital ownership types and, on some dimensions, Catholic hospitals are indistinguishable from other hospitals. This article conceptualizes United States Catholic hospitals as having competing institutional forces that are not always compatible. To keep pace with the changing demands of religion and the social role of the hospital, Catholic hospitals continue to redefine themselves. An adaptive framework is used to explain choices Catholic hospitals may need to make to justify their existence.