Gouvernance publique hospitalière : entre paradoxes et tensions. Le point de vue des cadres de santé
Over the years, hospitals have undergone a series of reforms (Debrosse, 2010; Dent, 2005), resulting in the implementation of a new form of hospital governance (Fray, 2009). The hospital has become a business (Vallancien, 2008), where a managerial rationale, inspired by liberal policies, comes up ag...
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| Auteurs principaux: | , |
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| Format: | Article ou chapitre numérique |
| Langue: | Français |
| Publié: |
2024
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| Accès en ligne: | Accès Université d'Orléans et IFPM Accès Université d'Orléans et IFPM |
| Résumé: | Over the years, hospitals have undergone a series of reforms (Debrosse, 2010; Dent, 2005), resulting in the implementation of a new form of hospital governance (Fray, 2009). The hospital has become a business (Vallancien, 2008), where a managerial rationale, inspired by liberal policies, comes up against the historical culture of care. We can now ask whether these new management methods can be integrated into public hospitals, and what are the inevitable paradoxes that may then arise. The aim of this article is to examine the point of view of healthcare executives in the light of this managerial rationale, to identify their perception of public hospital governance, as well as the prevalent tensions. Based on works by the Proximity School (Boschma, 2005), the aim is also to gain a better understanding of institutional paradoxes and tensions, and to identify the managerial role of healthcare executives. Does the solution lie in the governance model or in management itself? Semi-structured interviews with 40 healthcare executives, conducted in 2020, were analysed using the Alceste software. Two main results emerged: a better understanding of the nature of public hospital governance in the occurrence of the tensions observed, and the role of management in managing the tensions and paradoxes of the public hospital. |
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