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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.

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

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.

This study aims to understand whether and how the use of performance measures in the context of healthcare organizations facilitates the dynamics of compromise or whether it creates moral struggles among a wide variety of actors. It offers novel insights into the concept of hybridity by investigating its underlying moral dimension. Drawing upon the sociology of worth theory (Boltanski and Thévenot, 1991, 2006), this paper examines how actors negotiate and compromise over time concerning issues of justice, involving the use of performance measures on a day-to-day basis.

The article presents a single case study of a medical unit in a French public hospital. Data were obtained through the ethnographic method, semi-structured interviews and internal financial and accounting documents.

Unlike earlier accounting studies, the authors analyze whether, and how, accounting, on one hand, contributes to the dynamics of compromise between actors with divergent values that characterize hybrid organizations, and, on the other hand, increases tensions among actors with convergent values involved in caregiving. This offers practical insights into three relational mechanisms underlying the dynamics of compromise and their limits through the time dimension.

The authors use a single case study in a country-specific context.

This study helps managers of healthcare organizations to understand the relationships between the use of performance measures and their impact on the evaluation of worth in practice.

In terms of theoretical contribution, the authors show how the sociology of worth (Boltanski and Thévenot, 1991, 2006) complements the analysis of hybridity and develop an original approach to understanding the ambivalent role of performance measures in bringing together divergent values within French public hospitals.

The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial roles of doctors.

The paper is exploratory and is based on both the analysis of French literature dealing with the results of the 2009 reform, and ten semi-directed interviews with clinical managers and top leaders in the public hospital sector.

The author reports on the major hospital management reforms of 2009 and analyse the implications for the medical profession and management. The author shows that the involvement of the classical clinical leaders has become less regulated as the units no longer have a clear legal basis. The governance of the newly introduced “medical poles” appears to be shaped by various factors: there is high correlation between centrality, prestige and “clan involvement”, which suggests that professionals holding new responsibilities obtain power and legitimacy by consolidating pre-existing networks. While it is often argued that high-quality clinical leadership is a key factor of organisational success, the findings suggest that the performance of clinical managers relies on this network and legitimacy acquired from it.

Drawing on the “sociology of translation” and actor-network theory (Callon and Latour, 1991), this paper provides a new conceptual framework for the analysis of the transformation of the role of clinical leaders, arguing that this transformation depends highly on their abilities to build and use networks. The findings challenge the French tradition of public management that presupposes a clear division of power between doctors and administrative staff.

This paper aims to describe relationships among healthcare professionals in a French public hospital using social network analysis (SNA) and to improve health service quality by strengthening health service management and leadership.

This study was based on a questionnaire sent to randomly selected French public hospital professionals and administrators. Network composition measures were obtained using a name generator. Analysis focused on three main indicators: “centrality”, “prestige”, and “clique participants”. The SNA was carried out using UCINET^® and statistical analyses were performed with SPSS version 15.0.

A total of 104 questionnaires were returned and analysed. Centrality, prestige and clique indicators were highly correlated (all p‐value were less than 0.01). Physicians had the highest scores for the three indicators. Older age (≥45 years) was associated with higher centrality and clique numbers scores. Transversal activity was associated with higher scores than other specific activities (hospitalisation, ambulatory care), except for emergency care.

The paper shows how networks and SNA techniques provide novel and useful means to understand communication and collaboration between hospital professionals.

Concern over the rising cost of medical care has caused many countries to investigate and implement different methods of cost containment, particularly for hospital services. In the United States, Medicare replaced its ‘cost‐based’ reimbursement system, in which hospital payments were based on the actual costs incurred in treating patients, with a system that pays hospitals a fixed price per case. Under this new system, all hospital discharges are classified into 467 Diagnosis Related Groups (DRGs) or types of cases based on the patient's age, sex, principal diagnosis, additional diagnoses (comorbidities and complications), surgical procedures performed, and the discharge status. During the first three years of the programme, the payment rate for each DRG is a function of a DRG weight (reflecting relative resource consumption), the hospital's historic costs of treating patients in that DRG, and a federally established rate adjusted for urban/rural differences and census region. In the fourth year the price will be based only on the DRG weight and the federally established rate.

The purpose of this paper is to study the impact of spatial proximity on supplier selection in the French public sector. While French public procurement legislation forbids consideration of supplier location in the procurement process, public contractors may still rely on spatial proximity for complex transactions necessitating mutual adjustments with suppliers.

Using French Official Journals (BOAMP), the authors compiled 565,557 transactions completed on three public procurement markets between 6,182 contractors and 26,570 suppliers, over a period of six years (between 2006 and 2011). The authors conducted a two-level hierarchical linear auto-regression analysis and a feature evaluation analysis for all transactions.

The paper finds significant variation between the transactions on different markets: a negative effect of spatial proximity on the number of contract notices in the public market and a positive effect of spatial proximity on the number of notices in the services and supplies markets. The difference lies in the levels of mutual adjustment required to optimally manage the relationship between public contractor and supplier.

The research is based on an econometric analysis conducted uniquely in the French context, which calls into question the external validity of the results obtained. The study also rests on segmentation into three aggregate markets, which might be considered too general.

Rather than analyze public contractors’ perceptions of the importance of the criterion of spatial proximity, the paper examines 565,557 actual transactions. The results point to the emergence of a new type of relationship with certain suppliers, which should lead public contractors to integrate relationship management competencies, in addition to legal and economic competencies, in the organization of calls for tenders.

The purpose of this paper is to study if the performance history impacts supplier selection in the French public sector context. While French public procurement legislation forbids consideration of the past contract wins in supplier selection, public contractors may still rely on contract win history for highly complex transactions.

Using French Official Journals (BOAMP), the authors collected all public procurement transactions of 976 suppliers that had at least one transaction per year, over a period of six years (between 2006 and 2011). The authors conducted a two-level hierarchical linear auto-regression analysis and a feature evaluation analysis for all transactions.

The paper finds significant variation between the transactions of different markets, as well as in the overall positive impact of past wins and in the detailed impact patterns and thresholds of each market. The findings may allow refinement of existing contract awarding strategies and of current legislation.

The paper aims at empirically testing whether a supplier’s degree of success in any given year, measured by the number of public contracts won, may have an impact on the likelihood that the same supplier is awarded a public contract the following year. The authors conclude that suppliers retained for public contracts could benefit from building public buyers’ loyalty using a key account selling approach rather than systematically seeking to acquire new contracts.

The purpose of this paper is to show that the categorization of elderly patients as vulnerable is affected by health-care service interactions with caregivers, which may increase, reduce or even negate entirely elderly patients’ vulnerable status.

The paper reports the results of a qualitative study based on in-depth interviews conducted with a large and varied sample of health-care personnel in charge of elderly patients in two hospital geriatric departments in France.

Findings show that the limits of the service-dominant logic approach when the service (care) relationship concerns vulnerable individuals who are, completely or partially, unable to take part in the co-creation of the service and the roles played by caregivers as resource integrators (intermediaries, facilitatorapomediaries and transformativeapomediaries) and that this affects the categorization of elderly patients as vulnerable.

The results enrich knowledge about the service relationship with vulnerable people by showing that the categorization of elderly patients as vulnerable is not immutable but stems from the dynamics among actors that may variously “reify it” (contribute to its internalization), “reduce it” (enable access to aspects of normal life), or “neutralize it” (help free this cohort from their categorization as vulnerable).

The findings provide insights for care providers by stressing the need to raise awareness among hospital staff regarding their active role in affecting the categorization of elderly patients as vulnerable through their care practices. In the context of public health policies, the findings show that the regulatory injunction to empower patients to preserve their well-being tends to produce the opposite effect on the frailest patients, who are unable to participate in their care pathway.

The research shows that categorization as vulnerable, in the health-care services context, is affected by the care interactions between caregivers and elderly patients. The support provided to hospital staff in this context helps to maintain patients’ well-being and dignity.

In this study, an integrated decision-making model consisting of decision-making trial and evaluation laboratory (DEMATEL), best worst method (BWM) and a modified version of evaluation based on distance from average solution (EDAS) methods is proposed for supplier selection problem in a public procurement system considering sustainable development goals.

DEMATEL and BWM methods are used to determine weights of the criteria that are defined for the supplier selection problem. Weight aggregation method is applied to combine the weights obtained from these two methods. A modified version of EDAS method is then used in order to rank the alternative suppliers.

The proposed decision-making model is investigated for a supplier selection problem for a hospital in Spain. The validity of the results is checked using comparison with other decision-making methods and several performance analysis tests.

The proposed multi-criteria decision-making (MCDM) model contributes to the healthcare supply chain management (SCM) and aims to lead the policy makers in selecting the best supplier.

There is no such study that combines DEMATEL and BWM together for weight generation. The application of the modified EDAS method is also new. In real time situations, the decision experts may confront to the difficulty of using BWM while identifying the best and the worst criteria choices. The idea of using DEMATEL is to aid the experts to make them enable in distinguishing between the best/worst criteria and handle BWM easily.

The last few years have seen a stronger emphasis on patient-centred care within the international healthcare setting. Patient-centred care is clearly perceived to be important to optimise the satisfaction and well-being of patients. The purpose of this paper is to review current patient-centred practices for outpatients in both private clinics and public hospitals in Dubai. Such a comparison contributes to the identification of best management practices as a means of enhancing healthcare delivery.

This study is based on an independent survey consisting of self-administered questionnaires, in which patients were asked to rate several aspects of private clinics or government hospitals in Dubai. The questionnaire used has been drawn from the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey, Version 3.0. Responses from 420 patients form a data set that is analysed quantitatively.

In total, 420 respondents took part in this survey. The results of the survey show that there is a considerable difference between the expectation levels of patients from government hospitals and patients from private clinics. Patients from government hospitals consistently show that time is a critical aspect of the service received, with 68 per cent of the respondents reporting this issue. Additionally, poor customer care, as reported by 14 per cent of the respondents, is also a critical issue. Timely service and appointments are among the main factors that contribute to patient satisfaction. Patients in private clinics, instead, particularly value clear explanations from doctors and nurses – this is corroborated by the fact that 11 per cent of the respondents reported appreciation of this type of service.

This paper draws attention to a patient-centric perspective of healthcare, and highlights the importance of educating patients through clear explanations.

Little evidence exists on the standards of healthcare in Dubai. The authors explore this area and present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.