Une mesure régulière de la performance en matière de qualité de la prise en charge des malades est-elle possible? Enseignements d'une expérience concrète

The development of performance measurement systems focused on quality of care becomes a priority among public policy makers. This article shows that such a development requires to deal with different kinds of methodological problems, but then opens new perspectives and issues for researchers in economy and management. In a first part, we give different landmarks for developing a common language and a framework for performance measures. Then, we report the first results of a research engaged with The Private Hospital Union in France, and which is supported by the National Agency for Accreditation and Evaluation in Health care. We show three main rocks on which our research could have foundered: quality dimensions in regard to which no indicators can be found, indicators which can't be regularly used, and indicators developed without any metrological validations. In short, we identify different uses of these performance measures in the French context of quality improvement and control of resource allocation.