A gestão estratégica dos hospitais na França: balanço e perspectivas

The strategic management was introduced in French hospitals in the late 80s, in a context of inefficiency and the need to control healthcare expenditure. This concept has inspired a series of government reforms, the organization and dynamics of hospitals and the mode of regulating the French health system, assuming a real change of professional culture. The changes in the economic context and in the finance of hospitals, the behavior of users, the population aging, the development of chronic diseases and increased competition, are the new challenges to be faced. The involvement of stakeholders is crucial and the strategic management, based on mobilizing these actors, is today, a method of administration particularly well adapted to the health area. This article aims to present the impact of the concept of strategic management in the evolution of French hospitals and the consequences of these developments on the outlook for the dissemination of strategic management in the health sector. To do so, it is examined the evolution of the French context until 2010, the new challenges that French hospitals must face and, finally, the consequences of these challenges on how to design services, manage the relationships between the actors of the health system and organize the operational functioning of hospitals.