The impact of activity-based pricing (T2A) on the public hospitals’management

Abstract

Our purpose in this paper is to review the effects of activity-based pricing (T2A) after 12 years of implementation on management and organization of French public hospitals. It highlights, based upon literature that expected effects in terms of efficiency have only partially been realized. Public Hospitals have not thoroughly revised their processes and their organizations changes have been limited. These results are in agreement to deterioration in working conditions and loss of meaning that affects nurses and care teams and, sometimes, medical staff. To overcome these limitations, this article explores the paths of a truly medico-economic approach centered on the thinking design of new care processes based upon motivation of healthcare workers: the dynamics of medical innovation offering opportunities and improved quality and safety of care.