Business strategy and interorganizational linkages within the acute care hospital industry: An expansion of the Miles and Snow topology

A survey study was conducted to assess whether interorganizational coupling patterns varied within 2 domains as a function of increasing environmental turbulence and strategy type. The health care industry was chosen because macrodynamic sociocultural, technological, economic, and competitive trends dramatically altered its environment in the early 1980s. The study expands Miles and Snow's (1978) strategy gestalts by drawing from the literature on strategic choice, resource dependence, and loose coupling. Miles and Snow assume that organizations see what they wish to see in the external environment and can be proactive in dealing with it. The responses of 58 chief executive officers indicate that the strategy gestalts associated with Miles and Snow's topology have distinctive patterns or interorganizational coupling.