There are three purposes of this study: (1) to examine the legitimacy gaining model (the relationship between legitimation strategies and legitimacy) in the context of hospital industry, (2) to explore the influence of legitimacy gaining model on the process through which knowledge is created within hospital industry. (3) to explore the impact of hospital organizations' knowledge creation on hospital survival .This paper proposes an legitimacy gaining model as the determinants of hospitals'

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... ledge creation activities. Then we argue that the legitimation model of knowledge creation will further influence the survival chance of hospitals. We further suggest the managerial implication and theoretical implication at the end of this paper. The main managerial implication is that to comprehend the legitimacy-gaining model of legitimation strategies and legitimacy elements may help hospitals' managers to make effective strategies to create new, innovative knowledge and identify useful legitimacy factors, which may both assist and impede the creation of knowledge. The main contributions to organization theory are that we combine the perspectives of institutional theory and knowledge creation theory and explicate the relationship of these two concepts in the studies of health care management field.