Coûts hospitaliers en France: l'extravangante dérive des coûts administratifs

1/ Une dérive dans le temps: depuis les années 70 on peut estimer qu'en personnel l'administration a fait x 10
2/ Une inconnue car à l'heure actuelle il n'y a aucune statistique sur le coût de l'administration des hôpitaux en France. C'est si vrai que dans ce travail récent de Himmelstein les colonnes de ces couts ne sont pas remplies dans le tableau comparatif...

http://www.pnhp.org/publications/NEJM5_2_91.htm

Que s'est il passé depuis 1990?

la dérive continue:

"Using data from the Bureau of Labor Statistics (BLS) and the American Medical Association, my colleagues and I found that from 1990 to 2012, the number of workers in the U.S. health system grew by nearly 75%. Nearly 95% of this growth was in non-doctor workers, and the ratio of doctors to non-doctor workers shifted from 1:14 to 1:16. On the basis of BLS median wages, this equates to $823,000 of labor cost per doctor. Demand and supply are not growing in tandem: from 2002 to 2012, inpatient days per capita decreased by 12% while the workforce in hospitals grew by 11%. This misalignment underlies some of the productivity decline we have observed in health care. Fortunately, we anticipate demand for health care to grow in 2014, so to the extent that jobs are not added, productivity gains are possible. Unfortunately, health care as an industry continues hiring far faster than demand is growing, adding 119,000 new workers in the first half of 2013, for example, with little increase in patient volume."

https://hbr.org/2013/09/the-downside-of-health-care-job-growth/

http://thedoctorweighsin.com/the-rise-of-the-machine-how-hospitalpractice-admins-have-assumed-control/

http://thedoctorweighsin.com/the-rise-of-the-machine-how-hospitalpractice-admins-have-assumed-control/

En France difficile de trouver des données...
Il y a aussi ce très bon article:
http://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?_r=0
Et le débat interdit en France est celui là:
http://www.forbes.com/sites/alexknapp/2011/07/10/do-doctors-make-the-best-hospital-administrators/
Et cet article sur la surperformance des hôpitaux gérés par des médecins:
http://www.amandagoodall.com/SS&MarticletJuly2011.pdf

http://content.healthaffairs.org/content/33/9/1586.abstract