Évaluation des limites du contrôle par les règles comme instrument de gestion

comparaison des centres publics et privés d’accueil d’hébergement pour personnes âgées

Abstract

Economic models of institutional analysis demonstrate that structural reforms exert very limited impacts on services and that margins for maneuver of policy instruments concerning financial and regulatory interventions are very narrow. The study of a concrete setting, that of nursing homes for the elderly, indicates that rules regulating the allocation of staff and budgetary resources concern relations between producers and not the production of services. In addition, a study of 72 nursing homes indicates that manipulation of the rules regulating the allocation of resources has almost no impact on provision of services to the elderly. The data indicate that manipulation of these rules has significant impacts on the production of services only when they affect the organizational climate. This observation led the authors to suggest that improvements in the production of services require an investment in social capital, that is, an investment in the creation of values and attitudes positively affecting the behaviors of the producers of public services.