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La Pression Financière Interne, ses déterminants et ses effets sur les attitudes et comportements: le cas de l'hôpital public français.
Thèses et HDR   Open Access

La Pression Financière Interne, ses déterminants et ses effets sur les attitudes et comportements: le cas de l'hôpital public français.

Irène Georgescu
Doctoral, Université de Montpellier
06/12/2010

Résumé

Internal Financial Pressure control by results role conflict role ambiguity professional commitment public sector commitment organizational commitment data manipulation public hospital pression financière interne contrôle par les résultats conflit de rôle ambigüité de rôle implication dans la profession implication dans le service public implication dans l'organisation manipulation de données hôpital public.
The introduction of activity based pricing in combination with hospitals' reorganizations has recently created a new financial logic in French public hospitals. The organization has an obligation to produce certain levels of activity, since hospitals' resources are directly dependent on the activity level. These changes also imply the implementation of financial results controls in these organizations, which are traditionally dominated by professional control. The purpose of this study is to investigate the effects of financial results control in French public hospitals. The study comprises an exploratory study among 31 physicians in 2 public hospitals, and a confirmatory survey study among 578 doctors in 14 public hospitals. It documents the existence, origins and effects of internal financial pressures as a consequence of the said developments. The study documents how role conflict, role ambiguity, physicians' commitment and data manipulation depend on the nature and source of such internal financial pressures.

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