Dissertation (Doctoral) Entrepreneurship in Publicly-funded Hospitals: A Multi-case Study of Privately Funded Rehabilitation in Ontario Hospitals


Anna Ballon-Kaushansky


Ontario hospital spending represents the largest portion of the health care budget. Consequently, governments and publicly funded hospitals have implemented policies and strategies to decrease health care costs on the one hand, and on the other hand, to increase revenues from non-governmental sources. For hospitals, one revenue-generating opportunity includes partnering with privately funded rehabilitation companies or creating hospital-owned privately funded rehabilitation departments. The presence of parallel funding streams (public and private) for health care services departs from the political and organizational norms for Canadian hospitals. The primary objectives of this research are to characterize the organizational relationships between publicly funded hospitals and privately funded rehabilitation departments and companies, examine their effectiveness, and understand the benefits and/or disadvantages that these relationships afford hospitals beyond those originally anticipated. This study used mixed research methods within multiple case studies. Study results indicated that Ontario hospitals have employed numerous entrepreneurial strategies to increase revenues in addition to government funding. The relationships between hospitals and privately funded rehabilitation companies/departments allowed the relationship partners to achieve mutually beneficial goals by exploring and exploiting new and existing material and non-material resources. Nevertheless, hospital leaders have encountered political, social, and organizational tensions when related to the presence of privately funded health care services in hospitals. This study contributes to organization and management science by examining the utility of these relationships and the factors that hinder or facilitate relationship success. From a practical perspective, the findings of this study are of value to organizational leaders who may wish to establish and maintain effective relationships between publicly and privately funded companies in the context of the Canadian health care system.


Whitney Berta