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The focus of this review is macro-level organizational change in medical care organizations in the United States, with particular emphasis on the decade of the 1980s. We begin with a brief review of the historical context of this sector and discuss several important trends characterizing the industry since 1980. The body of this review focuses on major perspectives in organizational theory which either have been used or could be used to study these changes. We consider both determinants and consequences of change in the medical care sector.
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