TY  - CHAP
AB  - Abstract Whereas many researchers have examined the way in which health institutions have been transformed through funding modalities, and particularly through prospective payment systems (PPS), few have investigated the architecture of these systems, that is, costs and cost variance. Focusing on the study of costs and on the production of hospital rates, this chapter shows that the French PPS, called “rate per activity” made possible what we call a policy of variance. For health policymakers, the aim was to make the different accounting figures between hospitals, and between ways of practising healthcare, visible, in order to reduce these variances. This policy was attended by uncertainty in the processes of quantification, which led to metrological controversies. As a consequence of the issues around the way of calculating costs, some accounts and calculations were redone. In this chapter, we consider the case of metrological controversy over the remuneration of costs for cystic fibrosis patients’ hospital stays, and over the action of a patient organization that criticized the costs calculated officially. It leads to the analysis of the way calculative infrastructures, as cost accounting and rates, are challenged, and how some actors try to stabilize them.
VL  - 62
SN  - 978-1-78769-558-0, 978-1-78769-557-3/0733-558X
DO  - 10.1108/S0733-558X20190000062005
UR  - https://doi.org/10.1108/S0733-558X20190000062005
AU  - Juven Pierre-André
ED  - Martin Kornberger
ED  - Geoffrey C. Bowker
ED  - Julia Elyachar
ED  - Andrea Mennicken
ED  - Peter Miller
ED  - Joanne Randa Nucho
ED  - Neil Pollock
PY  - 2019
Y1  - 2019/01/01
TI  - Calculative Infrastructure for Hospitals: Governing Medical Practices and Health Expenditures Through a Pricing Payment System
T2  - Thinking Infrastructures
T3  - Research in the Sociology of Organizations
PB  - Emerald Publishing Limited
SP  - 69
EP  - 84
Y2  - 2024/09/19
ER  -