medical strategy and T2ain a local community hospital. Is it possible to transform constraint into opportunity?

Abstract

local general hospitals, which play an important rôle in the management of treatment in medicine,surgery, obstetricsin areas of healthcare, are confronted with specific difficulties in the system of pricing according to activity. The compatibility between maintaining a portfolio of medical activities which meets the needs of the population and is viable from a medico-economic point of view is not obvious. The hospital’s medical strategy aims to respond to this dilemma by exploring three things: the right validation of the activity, the consolidation of loss-making activities and the development of new activities. Consequently, access to adequate medical competence is crucial and necessitates the setting up of partnerships with reference and/or recourse hospitals. To meet fully their objectives, these cooperations must respect the parties’ interest to act, respect the primacy of the medical project and be economically balanced. Many examples show that this partnership strategy nevertheless does not constitute a response that is always sufficient for the dilemma studied. at the hospital level, T2a cannot be the way-in for medical strategies that should integrate other imperatives: access to care, medical demography, patient demand, and above all quality of the medicine delivered locally. only political choices can give the clarity necessary to local hospitals confronted with this situation.