Institutional logics, social interactions and management of tensions in public-private partnership organizations

We aim to understand the link between field-level institutional logics and practice-level social interactions and relationships between public and private actors and their influences on the responses and resolutions to the issues causing tensions.

Adopting a multiple logics perspective with a focus on social interactions and relationships between public and private actors, we conducted a multiple case study in five city hospitals recently established under a public-private partnership model in the Turkish healthcare field.

We found that the state and market logics that predominantly characterize the Turkish healthcare field were enacted in each of the five hospitals in different manners and constitute three different configurations as compatible, complementary and contradictory. The social interactions and relationships developed between the public and private actors occur based on these configurations, and they all together shape the responses and resolutions to the issues causing tensions.

Since we did all analyses between the organizational actors at the partnership level, we did not consider possible differences arising from individual and positional roles in each partnership. It is therefore important to acknowledge that the interviews, which are central to the research results, might be influenced by the motivation and power dynamics of the participants in terms of their positions, roles and responsibilities. Thus, much work must be done to understand the management of tensions in public-private partnership organizations (PPPOs) influenced by institutional logics with a greater focus on individual, partnership, organizational and field-level interactions.

Tensions arising between public and private actors in PPPOs can be understood better and managed more effectively when the enactment of institutional logics is considered together with their social interactions and relationships.

The novelty of our study is that we advance the knowledge on the management of tensions in PPPOs by empirically showing the link between field-level institutional logics and practice-level social interactions and relationships and their influences on the responses and resolutions to the issues causing tensions. Our results indicate that tensions arising between public and private actors in PPPOs are primarily responded to by private actors mainly with avoidance, defiance or decoupling and subsequently resolved by their joint efforts through informal collaboration, formalization, formalized collaboration, enforcement or coercive pressure, depending on how the state and market logics are enacted within the hospitals and how social interactions and relationships between public and private side actors are formed accordingly.