Budget pressures in hospitals : a qualitative study of RAPM among physicians

Based on the Reliance on Accounting Performance Measures (RAPM), this paper aims to propose a refl ection on the effect of controls by results introduced in French Public Hospitals. A exploratory study, based on 31 semi-structured interviews, try to understand the problematic of the RAPM and its impacts on attitudes and behaviors of the professionals in the public hospital sector. The results suggest the emergence of budget pressure which creates role conflicts, resistances and a tendency to data manipulation. Emphasizing the limits of previous researches on RAPM, this paper proposes to integrate a institutional and organisational views of the hospital.