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Some Suggestions for Improving Hospital Accounting Practices in Public Health Care Organizations

Jean de Kervasdoué ** Membre, Académie des technologies ; chroniqueur, Le ; professeur émérite, CNAM. Contact :
Alain SOMMER * Directeur, Medical Organisation Management ; enseignant, Conservatoire des arts et métiers (CNAM). Contact :

Management tools must keep pace with quick changes in the environment of health care institutions. The authors propose some avenues for improvement:

 – avoid the disadvantages of conglomerates by separating income statements, balance sheet accounts and financing accounts;

 – adapt the separation of authorizing and accounting officers to the new processes resulting from the IT revolution (artificial intelligence, robot process automation, platforms, e-admission, etc.);

 – redesign the work units of medical and technical services, in particular the relative cost indexes (RCI);

 – make “omogeneous patient groups” (GHM) more homogeneous in terms of treatment;

 – adapt the activity-based financing method to ensure the funding of capital investments;

 – better understand the reality of medical and technical cost centers;

 – define regular interim management accounts.

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