To read this content please select one of the options below:

Strategic responses to a high‐turbulent environment: The case of the French public hospitals

Sandrine Cueille (Institut d'Administration des Entreprises, Université de Pau et des Pays de l'Adour, Pau Cedex, France)

International Journal of Public Sector Management

ISSN: 0951-3558

Article publication date: 1 June 2006




This paper aims to characterize the French public hospitals (FPHs) according to their strategic behaviour. Until recently, FPHs used to ignore strategic issues, for their mission was clearly defined by regulating authorities and their activities were quasi‐automatically funded by the latter. This situation fundamentally changed as the environment of all “health care providers” became more demanding: FPHs have now to engage in a strategic process. The paper seeks to focus on the content of FPHs' strategies, and compare our results with standard findings of the strategic management literature, notably the strategic behaviour typologies established by Miles and Snow and Zaleznik and Kets de Vries.


A three‐stage empirical approach is conducted, mixing qualitative and quantitative methods. The measurement stage, based on a questionnaire survey realized with the support of a professional union, gathered the answers of 276 FPHs' decision‐makers, representing 51 per cent of the target population. This stage allows the formation of classes among these respondents, according to the environmental, organisational, and strategic features they describe.


The results are globally consistent with Miles and Snow's and Zaleznik and Kets de Vries' typologies. This is noteworthy since they were obtained in a different context and with different methodological approaches.

Research limitations/implications

This article tackles the issue of the universality of the strategic process.

Practical implications

Finally, implications for policy makers and hospitals' managers are drawn from the study.


What mostly differentiates the paper' results from the standard typologies is that FPHs can be separated according to the alliances criterion.



Cueille, S. (2006), "Strategic responses to a high‐turbulent environment: The case of the French public hospitals", International Journal of Public Sector Management, Vol. 19 No. 4, pp. 359-383.



Emerald Group Publishing Limited

Copyright © 2006, Emerald Group Publishing Limited

Related articles