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Analyse des fusions hospitalières sur longue période : un changement institutionnel

Author

Listed:
  • Laetitia Laude

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Michel Louazel

Abstract

Parmi les formes de restructuration, la fusion s'est imposée aux établissements depuis le début des années 1990. Sans parvenir à démontrer son efficacité en matière de recomposition de l'offre de soins, la fusion constitue un processus de changement institutionnel. Après une période de fortes incitations, il semble que les opérations de coopération soient désormais privilégiées aux opérations de fusion. Notre article interroge, à travers l'analyse longitudinale de cinq opérations de fusion, les mécanismes de changement institutionnel à l'œuvre. Nous montrerons les apports de l'approche néo-institutionnaliste dans l'analyse des processus de changement imposés d'une part. D'autre part, nous discuterons en quoi ces approches dessinent une vision de la performance en santé au confluent entre rationalité et conformité.

Suggested Citation

  • Laetitia Laude & Michel Louazel, 2013. "Analyse des fusions hospitalières sur longue période : un changement institutionnel," Post-Print hal-01507452, HAL.
    • Handle: RePEc:hal:journl:hal-01507452
    DOI: 10.3917/jgem.132.0093
    as

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