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The traditional myth of public management portrays public organizations as possessing unique attributes and operational dynamics that set them apart from private organizations. In particular, public organizations have been perceived as inferior to their private sector counterparts in terms of productivity, while often being seen as having a greater focus on equity outcomes or benevolence (Bok, 2001; Hvidman & Andersen, 2016). However, the boundaries between public, private, and non-profit organizations have become increasingly blurred in contemporary society, challenging the traditional division between public and private sectors (Provan & Milward, 2000; Salamon, 2002; Overman, 2016). Publicness theory proposes that organizational publicness is not a binary distinction but rather a continuum (Bozeman, 1987). All organizations exhibit both publicness and privateness, and degree of these elements shape their behaviors, dynamics, and outcomes. Furthermore, the integrative publicness theory focuses more on three dimensions of publicness – ownership, government funding, and political and economic controls – and how these elements can make up the performance or public value creation (Bozeman & Bretschneider, 1994; Andrews et al., 2011; Choi et al., 2021). In this regard, debates over the public-private divide now frame public service organizations along a continuum of publicness, indicating the intricate dynamics inherent across that spectrum. However, despite longstanding stereotypes attached to the public-private divide, we have scant empirical evidence on how the different dimensions of publicness influence various performance outcomes, aligned with the traditional myths in performance management, while prior works have found that publicness can shape managerial practices, operations, and service outcomes (Rainey, 1983; Goldstein & Naor, 2005; Choi & Berry, 2021).
This study investigates how the three dimensions of publicness – ownership, funding, and political and economic controls – affect different types of organizational outcomes, especially for productivity (effectiveness and efficiency) and equity outcomes. Using a dataset of general acute care hospitals in the U.S. from 2013 to 2020, the study employs panel ordered logit, tobit, and two-way fixed effect regression to assess the how different performance outcomes are determined by multi-dimensional publicness.
Preliminary results have shown that each dimension of publicness is differently associated with effectiveness, efficiency, and equity outcomes. Contrary to the myth of public ineffectiveness and inefficiency, non-profit and public hospitals demonstrate higher effectiveness and efficiency as well as more engaging equity outcomes than private hospitals. On the other hand, from the economic control, higher competition can boost productivity but reduce equity outcomes. In funding stream, it has shown mixed findings drawn from its contextual influences. This study contributes to a theoretical understanding of the complex dynamics between multi-dimensional publicness and organizational performance and provides empirical evidence that shed light on the myth of performance management in a continuum of publicness.