000			01926naa a2200181uu 4500
001			0110912555937
003			OSt
005			20190218141918.0
008			101109s1987 xx ||||gr |0|| 0 fre d
100	1		_aMOISDON, Jean-Claude _942389
245	1	0	_aLa tutelle locale sur les hôpitaux : _bses instruments et ses contraintes
260			_aParis : _bIIAP, _cjuil./sept. 1987
520	3		_aThe local health authorities (DDASS) are a favorite target of criticism when discussing public health. But what are their duties, limited and operating mechanisms? They oversee and coordinate the establishment of new facilities, and approve annual budgets and long-term policy for hospitals. They stand between two opposing forces, i.e. central government trying to hold dowm hospital costs through the national equipment allocation plan plus various rules and procedures, and local interests seeking to maintain and even expand hospital facilities. This has given rise to a policy of 'inching along' and compromise that bows to quantitative targets set by central government without openly opposing local demands. Likewise, they exercise their authority very cautiously, interplaying with a number of organizational factors internal to hospitals, e.g. no indicators to account for hospital activity, bookkeeping unrepresentative of institutional operations, long and unwidely reports, insufficient staffing with bureaucratizing training and hermetic career paths. The underlying conflict between national objectives and local demands will not be resolved in the medium term. The only bridle possible would be management and evaluation tools to re-orient hospital activites towards specific objectives
773	0	8	_tRevue Française D'Administration Publique _g43, p. 59-70 _dParis : IIAP, juil./sept. 1987 _xISSN 01527401 _w
942			_cS
998			_a20101109 _b1255^b _cDaiane
998			_a20101122 _b1456^b _cCarolina
999			_aConvertido do Formato PHL _bPHL2MARC21 1.1 _c37212 _d37212
041			_afre