THE ANSWERS OF MANAGEMENT CONTROL  TO THE NEW NEEDS OF

THE PUBLIC HOSPITALS IN FRANCE

René KIEFFER                                  Yvon MERLIERE

Professor at Paris School of               Director assistant

Graduate Management                   National Health Insurance Headquarters

               ESCP-EAP                            CNAM

 

Abstract

 

The general evolution of our society takes many different forms. It very often forces people and institutions to adapt or even to transform themselves deeply. Public hospitals are no exception.

In this context, one observes growing difficulties in reconciling four major constraints:

- To make the most of budgets which grow less rapidly than the needs they are supposed to meet;

- To provide quality healthcare, in response to the demand expressed by patients;

- To support the quest for medical excellence, that is for progress;

- To integrate each hospital's action in the framework of local and national policies.

Today, management control offers a constantly improving degree of experience as concerns tools and methodologies, in order to meet needs both in the short and medium term.

One of the main assets of management control is that its participative approach calls on all the different functions of a hospital, during both the preparatory and measurement stages of tool preparation, and the follow-up ones
Today, management control must help integrate in the general management of hospitals both ambulatory cares as the necessary follow-up of some treatments, and the networked provision of hospital care at different (local, regional and national) levels.

Management control lies at the heart of data collection and processing. Its implementation in hospitals makes it a growingly valuable decision-making tool. Over time, its missions have changed along with the need for relevant information and the tools, which are available to process it. Two main trends can be noticed as concerns the need for information:

- The growing association of both qualitative and quantitative indicators in order to aid in the restructuration of activities in the medium and long term.

- Two major groups of tools are becoming indispensable to aid in the decision-making process:

            * Cost Accounting, in order to collect financial and activity data;

            * Statistical and econometric tools, including surveys and polls.

The two groups of tools essentially aim at improving our understanding of real costs compared to the budgets, activities and projects of hospitals, in order to meet the requirements of patients and staff alike.

This presentation aims introducing new- or development-stage techniques, which correspond to the new requirements of healthcare management. The techniques will be presented along with a practical way to implement them.

Addresses:   René Kieffer: at ESCP – kieffer@escp.fr

Yvon Merlière: at CNAM – yvon.merliere@cnamts.fr