Tarification publique et normalisation des processus de production dans le secteur de l'aide à domicile pour les personnes âgées

A survey conducted in six French departments reveals pricing practices in home care services for old-age persons. Within the current legal framework, the general rule is to set an hourly financing rate corresponding to a theoretical total cost based on the draft budgets submitted by home care services "readjusted" according to local production process standards. Such standards, which are more or less explicit, apply to the allocation of common expenses, the structure of the labour force, the organisation of working time, and commuting expenses. Hence, pricing appears as a standardisation tool for production processes, via budgetary incentives. Nonetheless, such standards are applied more or less strictly. Indeed those who set rates have problems collecting information enabling them to define relevant standards. On the other hand, these standards suffer a lack a legitimacy in a context of potentially contradictory political objectives - such as quality of services versus quality of jobs -, all the more so as these objectives are not clearly stated by public authorities.