Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française

How costs and tariffs have become pivotal policy instruments to govern public hospitals in France since the early 1980’s? What kind of controversies do they produce and what feedback effect do these controversies have on these instruments? These are the questions I propose to answer in this PhD diss...

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Main Author: Pierre-André Juven
Format: Article
Language:English
Published: Association Recherche & Régulation
Series:Revue de la Régulation
Subjects:
Online Access:https://journals.openedition.org/regulation/10872
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author Pierre-André Juven
author_facet Pierre-André Juven
author_sort Pierre-André Juven
collection DOAJ
description How costs and tariffs have become pivotal policy instruments to govern public hospitals in France since the early 1980’s? What kind of controversies do they produce and what feedback effect do these controversies have on these instruments? These are the questions I propose to answer in this PhD dissertation by analysing the genealogy, the uses and the transformations of several policy devices: information system, cost accounting, budgetary regulation instrument and pricing payment system. Combining a sociology of policy instruments and science and technology studies, these devices are analysed in the multiple sites where they spread: ministry of Health, public agency, research centres in management studies, hospital federations, patients organizations and public hospitals. The dissertation exposes how these devices have turned public hospitals into accounting and financial entities. I specially focus on the pricing payment system (called T2A) which is analysed as a qualculation instrument as it qualifies and quantifies patients, stays in hospitals, diseases, and public hospital itself. The dissertation shows how this qualculation process produces metrological controversies in which actors put into question the way things are qualculated.
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spelling doaj.art-e4aea87ea86342ffb9dc550df78f90b52024-02-13T13:01:52ZengAssociation Recherche & RégulationRevue de la Régulation1957-77961610.4000/regulation.10872Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière françaisePierre-André JuvenHow costs and tariffs have become pivotal policy instruments to govern public hospitals in France since the early 1980’s? What kind of controversies do they produce and what feedback effect do these controversies have on these instruments? These are the questions I propose to answer in this PhD dissertation by analysing the genealogy, the uses and the transformations of several policy devices: information system, cost accounting, budgetary regulation instrument and pricing payment system. Combining a sociology of policy instruments and science and technology studies, these devices are analysed in the multiple sites where they spread: ministry of Health, public agency, research centres in management studies, hospital federations, patients organizations and public hospitals. The dissertation exposes how these devices have turned public hospitals into accounting and financial entities. I specially focus on the pricing payment system (called T2A) which is analysed as a qualculation instrument as it qualifies and quantifies patients, stays in hospitals, diseases, and public hospital itself. The dissertation shows how this qualculation process produces metrological controversies in which actors put into question the way things are qualculated.https://journals.openedition.org/regulation/10872pricing payment systemcost accountingpublic hospitalspolicy instrumentsfinanciarizationcritical qualculation
spellingShingle Pierre-André Juven
Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française
Revue de la Régulation
pricing payment system
cost accounting
public hospitals
policy instruments
financiarization
critical qualculation
title Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française
title_full Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française
title_fullStr Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française
title_full_unstemmed Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française
title_short Pierre-André Juven, Une santé qui compte ? Coûts et tarifs dans la politique hospitalière française
title_sort pierre andre juven une sante qui compte couts et tarifs dans la politique hospitaliere francaise
topic pricing payment system
cost accounting
public hospitals
policy instruments
financiarization
critical qualculation
url https://journals.openedition.org/regulation/10872
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