The Evolution of Hospice in America Toward Organizational Homogeneity

Abstract

This article describes and explores the evolution of hospice in America. Using a theory of organizational isomorphism developed by DiMaggio and Powell (1983), the authors assess the development of hospice under conditions of uncertainty, co-optation by external forces, and professionalization by existing health care practitioners. The authors find that hospice programs have become isomorphic over time. That is, they have become more similar to each other as well as to other health care organizations.