Financement par la T2A, vision médicale hospitalière (notice n° 689291)
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| 000 -LEADER | |
|---|---|
| fixed length control field | 02736cam a2200241 4500500 |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20250121205633.0 |
| 041 ## - LANGUAGE CODE | |
| Language code of text/sound track or separate title | fre |
| 042 ## - AUTHENTICATION CODE | |
| Authentication code | dc |
| 100 10 - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Gervais, Anne |
| Relator term | author |
| 245 00 - TITLE STATEMENT | |
| Title | Financement par la T2A, vision médicale hospitalière |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Date of publication, distribution, etc. | 2015.<br/> |
| 500 ## - GENERAL NOTE | |
| General note | 12 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Depuis 10 ans la tarification à l’activité (T2A) est devenue le socle du financement hospitalier. Répondant à une vision productiviste du soin, la T2A a permis une augmentation de la productivité hospitalière mais s’est révélée inflationniste et inadaptée pour une partie de l’exercice médical hospitalier. Adapté aux pathologies et actes standardisés, ce mode de financement est imparfait pour permettre la prise en charge des patients complexes, polypathologiques, porteurs de maladies chroniques ou précaires, nécessitant un temps de réflexion médical pluridisciplinaire et non technique. La T2A s’est accompagnée d’une complexification du système de codage, souvent chronophage pour le personnel. Ce dernier constate que développer des activités « rentables » devient une préoccupation centrale et que la réponse aux besoins sanitaires n’est plus prioritaire. Enfin le financement actuel à la T2A ne permet pas de soutenir l’innovation et les investissements lourds. Une réforme du financement de l’hôpital est attendue par les professionnels de santé qui déplorent la lenteur des modifications. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | DRG payment (DRG-P) has been implemented in French Hospitals for 10 years. DRGP was a potent incentive to increase hospital productivity but had inflationist effects and contributed to inappropriate medical practices, while suitable for standardized diseases or medical interventions, this type of funding is imperfect in supporting innovation or the management of patientswith social vulnerabilities or those with multiple pathologies and of chronic diseases carriers. It does not take into account non-technical medical time. Nevertheless, a complicated, and time consuming, coding system was implemented together with DRG-P. Attention was focused on the most profitable activities, instead of the most appropriate responses to medical needs. A reform of hospital funding is hoped for health professionals who deplore the slowness of change. |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | financement |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | tarification à l’activité |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | hôpital |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | funding |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | hospital |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | diagnosis related group |
| 786 0# - DATA SOURCE ENTRY | |
| Note | Journal de gestion et d'économie médicales | 33 | 2 | 2015-11-24 | p. 117-122 | 2262-5305 |
| 856 41 - ELECTRONIC LOCATION AND ACCESS | |
| Uniform Resource Identifier | <a href="https://shs.cairn.info/revue-journal-de-gestion-et-d-economie-medicales-2015-2-page-117?lang=fr&redirect-ssocas=7080">https://shs.cairn.info/revue-journal-de-gestion-et-d-economie-medicales-2015-2-page-117?lang=fr&redirect-ssocas=7080</a> |
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