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T2A et contrôle de gestion ou l'art de la mesure

Abstract : The healthcare sector which has faced all sorts of reforms over the last thirty years is, in France, a privileged area for public policies since what is at stake is at the heart of the transformations of society. In this ever-changing context, the setting up in 2004 of a fee for service system (T2A) marked a new stage which raises questions for the researcher and for users on at least 2 points: ? How do public policies build capacity for specific action for those in the field? ? Like all measurement systems, those which give account of activity or financial management are not neutral. Consequently how are they set up and do they diverge from their initial principles? We will base our discussion on a study carried out in 150 hospitals followed by the MEAH1 from 2006 to 2009 in the context of the setting up over a period of several years of analytical accounting by centres, complemented by data collected by students training to be managers at the EHESP during the period 2004/2010. We conclude that T2A does not seem to have had, to date, strong direct consequences on the reorganisation of work processes in medical centres and healthcare services. This does not mean that T2A had no effect on management ; it is this paradox that has to be analysed.
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Submitted on : Tuesday, March 22, 2022 - 4:07:57 PM
Last modification on : Wednesday, March 23, 2022 - 3:14:02 AM

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Laetitia Laude, Philippe Peyret. T2A et contrôle de gestion ou l'art de la mesure. Journal d'Economie Médicale, Masson, 2011, 29 (4), pp.141. ⟨10.3917/jgem.114.0141⟩. ⟨hal-03616570⟩

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