• Health Care Administration;
  • Organization;
  • Management Theory;
  • Strategy;
  • Policy.

This paper presents an empirical analysis of the determinants of interorganizational cooperation among hospitals. Hospital administrator felt needs for programs of interhospital cooperation and actual cooperative outcomes by their hospitals are examined. A combination of survey and archival data is used to test several research hypotheses. Results support separating the interorganizational activities of hospitals into those related to medical and those related to ancillary service areas. Felt needs to cooperate in both service areas are influenced by administrators' concerns for hospital autonomy and image in interorganizational relations. Perceived availability of cooperation partners affects felt needs to cooperate only in the area of medical services. Actual levels of cooperative activity in medical services are related to perceived manpower resource scarcity, historical levels of cooperation, and concerns for hospital image in interorganizational relations. In ancillary services, actual levels of cooperation were related to perceived financial resource scarcity, historical levels of cooperation, and perceived availability of cooperation partners. Felt needs to cooperate were not associated with actual cooperative outcomes in either service area. The results contain implications for future research into the decision processes that give rise to interorganizational relationships of cooperation.