In-house statistical services for social security and guardianship administration have shown strong sustained growth in the past decade. Such service were started decades after comparable services for business, industry and agriculture. Quality has improved and the scope of investigation has broadened despite recent budget restrictions.

However:

1. Statistical services grew in specific directions that served the purposes of the sponsoring institutions: the regulation of the health care made available, and hospital management and, on the other hand, a detailed knowledge of private practise to lay the groundwork for fee-setting negotiations. Such institutional thinking has not the monopolized all statistical investigation for the past 10 years, yet it does predominate.

2. French physicians enjoy privileged social status that prevents any outside body from exerting true control over the profession. For example, the NGAP standards fees list acts as a buffer that mediates transactions between the profession and the social security administration. The jurisdiction of the Medical Association is yet another way the medical community policies itself prevents intervention from external societal bodies.

For these reasons, it remains very difficult to collect some data certain statisticians consider useful to forming a representative picture of health care institution clienteles, especially the most 'medical' of all data: diagnoses