1. Governance tensions in the healthcare sector: a contrasting case study in France
- Author
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Laurent Mériade, ROCHETTE Corinne, Clermont Recherche Management (CleRMa), École Supérieure de Commerce (ESC) - Clermont-Ferrand (ESC Clermont-Ferrand)-Université Clermont Auvergne (UCA), chaire Santé et Territoires (S&T), Institut d'Administration des Entreprises - Clermont-Auvergne (IAE - UCA), and Université Clermont Auvergne (UCA)
- Subjects
business.industry ,Health Policy ,Research ,healthcare organisation ,Corporate governance ,Health Care Sector ,Public administration ,contrasting study ,[SHS]Humanities and Social Sciences ,Physicians ,Political science ,Health care ,Humans ,[SHS.GESTION]Humanities and Social Sciences/Business administration ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,Health Facilities ,Public aspects of medicine ,RA1-1270 ,business ,Delivery of Health Care ,Governance tensions - Abstract
BackgroundPolitical and managerial reforms affect the health sector by translating into governance tensions. As identified in the public management literature, these tensions come from the diffusion of management principles and practices from the business world. These tensions manifest at four levels: institutional, organisational, managerial and instrumental. The aim of this research is to understand how these tensions are expressed in healthcare organisations of different status.MethodsWe conduct a contrasting case study exploring the cases of two French healthcare organisations, one private for-profit (clinic) and one public not-for-profit (cancer treatment centre). Our analyses are mainly based on the content analysis of 32 semi-structured interviews conducted with staff (nurses, doctors, management and administrative staff) of these two organisations.ResultsOur results show that these tensions can be distinguished into three categories (tensions on professional values, standards and practices) which are expressed differently depending on the type of healthcare organisation and its main management characteristics.ConclusionsUnexpectedly, in the for-profit organisation, the most intense tensions concern professional standards, whereas they concern professional practices in the not-for-profit organisation. These analyses can help guide policy makers and healthcare managers to better integrate these tensions into their political and managerial decisions.
- Published
- 2022