Challenges in Changing Healthcare Resource Allocation – Separation, Integration, or Diversification of Institutional Logics

This study explores how resource allocation practices in healthcare have been applied and discussed under the governance logics of Public Administration (PA), New Public Management (NPM), and New Public Governance (NPG), and how these logics interact with and manage conflicting field-level logics, particularly the medical-professional and market-managerial logics. A systematic literature review (SLR) is performed, following the PRISMA framework, using the databases Web of Science Core Collection (WoS) and Scopus. 55 articles out of 816 potentially relevant studies published within a broad range of disciplines between 2005 and 2025 met the inclusion criteria. The SLR reveals that governance logics not only inspire new resource allocation practices but also embody distinct rationalities for managing field-level conflicts. Under PA, field-level logics are separated through layering, NPM attempts integration through blending of field-level logics, and NPG introduces bridging field-level logics to accommodate diversity. Despite extensive research, there is limited understanding of how governance logics manage co-existing and conflicting field-level logics. This knowledge gap undermines effective resource allocation policy design and implementation. The study contributes by clarifying the vertical interplay between governance and field-level logics and by offering insights into how healthcare resource allocation can improve by aligning new practices with institutional contexts.