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AbstractRecent innovations in representative bureaucracy push the theory toward the micro‐foundations of who represents and who receives representation. Contributing to the micro theory, I draw from street‐level bureaucracy which recognizes how certain client characteristics beyond a shared identity may make representation too costly. Using data on emergency department visits to Florida hospitals, I explore how the impact of physician‐patient gender matching on client outcomes is moderated by a patient's insurance status. While emergency departments offer universal, public access, services performed on publicly insured and uninsured individuals are reimbursed at a lower rate than the privately insured. These features present an opportunity to test how responsive representation is to different client costs and benefits. The findings suggest that public insurance status is not a barrier for women's representation. However, uninsured women do not see any improvement in outcomes when receiving representation.

What is the link between administrative capacity and wicked problems? Previous literature links capacity to standardized performance outputs, but little is known on the link between capacity and highly complex policy settings. This study examines health outcomes of the opioid crisis—a wicked problem with interdependencies across different drugs with multiple legal and illegal pathways for abuse and dependence. If capacity matters for wicked problems, administrative action should decompose the larger wicked problem into smaller, more achievable solutions. The findings suggest that administrative capacity may allow public organizations to simultaneously manage drug outcomes across the legal and illegal market.

Diversity management has received considerable attention in public management research. Most existing research, however, analyses the effects rather than the determinants of diversity management. Using panel data on American hospitals from 2008 to 2011, we probe how market competition, inter‐organizational collaboration and clientele diversity affect diversity management adoption. We find that all three environmental factors increase diversity management adoption. Hospitals in competitive markets are more likely to adopt diversity management strategies when they engage in extensive service collaboration and serve a diverse population. Monopolies in less collaborative environments lag behind in adopting diversity management, especially when they serve ethnically homogenous populations. Our findings broaden understandings about what drives diversity management practices and add to the literature on the external contingency of managerial practice.

AbstractA growing literature identifies the external environment as a key driver of diversity management in frontline public services. With many public services spanning the public, nonprofit, and private sectors, the degree to which ownership moderates the link between the environment and diversity management practice is an important area that has received little attention. Using longitudinal data on nearly 4,000 American hospitals from 2008 to 2012, we explore how public, nonprofit, and private hospitals diverge in their responses to three environmental factors—market competition, inter-organizational collaboration, and the racial diversity of the population in their local service area. Findings from random effects panel models and panel logistic regressions suggest that these factors are associated with heterogeneous diversity management activities across different sectors. For public hospitals, diversity management is influenced by the racial diversity of clients. Nonprofit hospitals' diversity management is influenced by both inter-organizational collaboration and the racial diversity of clients. Market competition is the main driver of diversity management in the private sector. These findings bring insights from contingency theory and the cross-sector comparison literature into diversity management research. Key findings suggest there are complex and multiple mechanisms guiding diversity management practices across different sectors.

AbstractAlthough demographic diversity has been of paramount concern to researchers and practitioners in public management, studies exploring managerial strategies to capitalize on and respond to the needs of diverse client populations are scarce. This article examines strategies for managing diversity as a way to buffer environmental challenges in service delivery and performance resulting from heterogeneous client demands. Findings suggest that administrators prioritize diversity efforts when faced with higher levels of regulatory violations (a performance measure). A higher percentage of black residents is associated with lower service quality. However, the effect of managerial strategies for diversity on performance is conditioned by the racial composition of the clients: as the percentage of black nursing home residents increases, diversity management efforts are associated with a lower number of regulatory violations. Similarly, at higher levels of racial heterogeneity, diversity management efforts are associated with fewer regulatory violations.