Modern hospitals are networks of organizations

Objective: To study how hospitals and their diagnosis and treatmentsupplies relate to each other, analyzing if they have market relations orbehave as networks of organizations. Furthermore, the study tries toset the consequences of such relation in terms of access to knowledge,learning and innovation. Methods: A multiple case study performedat four top large private hospitals in São Paulo (Brazil), involving theiroutsourced laboratory, imaging and hemotherapy services. Individualinterviews were conducted with managers and owners of bothorganizations (hospitals and vendors) using semi-structured questionsto ascertain selected independent and dependent variables. The analysisused pattern-matching techniques. Results: The study demonstratedthey behave as networks. There are standard and complex interactions,with mutual exchange of knowledge and learning. There is strategic andoperational collaboration to find solutions, generating new products andservices and implementing new technologies. The relationships are longstandingand actions are interdependent. It is not a typical client-supplierinteraction neither a characteristic expression of hierarchy. Conclusion:the present paper can provide useful information to prepare a quantitativeresearch tool; based on this information, it is possible to estimate theadequate size of a representative sample