ABSTRACT
Administrative restructuring is an organizational phenomenon suggested to improve under-represented groups’ managerial representation by disrupting networks and institutions. However, extant tests of a ‘disruption hypothesis’ are collectively inconclusive. We elaborate and test it with a qualitative-to-quantitative study of local health agency managers and mergers across the Italian NHS from 2014 to 2020. Agency leader interviews reveal disruption indicators: number of agencies merging, staff rationalization, changes in geographical scale, and agency heterogeneity. Using administrative data, we find disruption measures have some positive associations with women’s share of management, post-merger retention, and new hires, providing modest support for the disruption hypothesis. However, there is an unexpected ‘winners-and-losers’ dynamic: incumbent women had higher post-merger attrition than men, but merged agencies hired more women than non-merging agencies. We offer three abductively developed interpretations of this finding, extending the disruption hypothesis’ connections with public management theory on the informal, organizational antecedents of diversity in senior management.