Hopital de Pontoise

In 2010, Andre Razafindranaly, Managing Director of a large French public hospital, considers which organizational structure will help them adjust to the changing health sector environment. The move from global budget to activity-based funding has led his and many other public hospitals to suffer losses in recent years. Appointed two years previously, Razafindranaly introduced increasing financial control and encouraged organizational changes such as multidisciplinary wards differentiated by patients' lengths of stay. To what extent should he (and can he) reinforce these measures, which have increased efficiency and reduced the deficit, but also generated push-back from his doctors and staff?Learning Objective:To introduce students to the challenge faced by public health institutions in a changing regulatory and competitive environment