Technocratic recentralization in the French health care system: A critical evaluation. (23rd December 2018)

• Record Type: Journal Article
• Authors: Simonet, Daniel
• Is Part Of: International journal of health planning and management. Volume 34:Number 2(2019)
• Page Start: 824
• Page End: 835
• Publication Date: 2018-12-23
• Subjects: administrative restructuring -- evidenced‐based policy -- health system -- recentralization; Health planning -- Periodicals; Health services administration -- Periodicals; Santé publique -- Planification -- Périodiques; Santé, Services de -- Administration -- Périodiques; 362.1068
• DOI: 10.1002/hpm.2740
• Languages: English
• ISSNs: 0749-6753

Abstract

Summary: The French health care system implemented several corporate management recipes such as diagnostic‐related groups (DRGs), benchmarking, and activity‐based management in a bid to restore fiscal discipline and to "reassert the center." The government also regrouped health policy decisions with the Regional Health Agencies and opted for a top‐down line of command to ensure policy implementation. Though reforms emphasized evidenced‐based policy and outputs measurement, outcomes were below expectations in many areas and led to a shift in values. Professional autonomy and patient engagement receded. This leads us to a critical evaluation of the French audit society.