Stratification and Hospital Care: II. The Performance of the Medical Interne (1961)

This is the second of two papers which involve a “triangulation” on medical performance in an effort to test the proposition that organizational stratification is related to hospital care. The triangulation consists of the measurement of performance from the subjective, reputational, and objective points of view. The present paper presents evidence based upon the objective medical records. The evidence is organized around a conception of the hospital as an institution performing seven key functions. Criterion measures related to these seven functions are examined, and it is shown that units which differ in their degree of stratification also differ in their performance with respect to a number of these criteria (e.g., the length of patient stay, and the use of the consultation process). Taken together, the two papers show that when performance is independently measured in three fundamental ways, there is a basic congruence which supports the proposition that the degree of stratification of organizational units is related to variations in task performance.