Motivational paradigms for the integration of a Belgian hospital network and merger presented in the printed press

Purpose Legitimizing health-care networks over time is crucial to the survival of the networks, but studies providing insight into the motivational paradigms used to legitimize networks and mergers are missing. This study aims to contribute by analyzing which motivational paradigms, namely, transaction costs economics, resource dependency, stakeholder theory, organizational learning and institutional theory, are used over time to motivate the formation, integration and eventually merger of a health-care network. Design/methodology/approach The theoretical paradigms from the literature are matched with the motivational arguments that were found in the communication around the formation and evolution of a specific health-care network. Secondary data in the printed press were analyzed in three ways to obtain triangulation in method. Findings Five theoretical paradigms matched the communication during significant parts of the time-scope of the study, but not always equally strong. It, therefore, confirms the usefulness of an integrated and evolutionary perspective on the paradigms, not only during the formation but also during the life-span of the organization. Originality/value Insight into the motivational paradigms that dominate in the press during an integration and merger process allows for health-care managers and policy makers to manage the process of legitimizing. This might prevent network failure because of lack of legitimacy, misperceptions of the motivations, overemphasizing one motivation or inability to move to a next layer of motivation when the integration process evolves.