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Article . 2025
License: CC BY
Data sources: Datacite
ZENODO
Article . 2025
License: CC BY
Data sources: Datacite
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La tarification à l'activité (T2A) comme système de gestion de la performance hospitalière : une analyse bibliométrique

Activity-based funding (ABF) as a hospital performance management system: a bibliometric analysis
Authors: JAOUHER, Anass; BOUAZZAOUI, Rian; HILMI, Yassine; HAMMOUCH, Ridouan;

La tarification à l'activité (T2A) comme système de gestion de la performance hospitalière : une analyse bibliométrique

Abstract

Les réformes contemporaines du financement hospitalier ont profondément transformé les mécanismes de pilotage de la performance des établissements de santé. Parmi elles, la tarification à l’activité (T2A), fondée sur les systèmes Diagnosis-Related Groups (DRG), s’est progressivement imposée comme un instrument central de régulation, combinant des logiques de financement, de contrôle de gestion et d’évaluation de la performance. Cet article propose une analyse bibliométrique de la littérature scientifique internationale consacrée à la T2A/DRG en tant qu’outil de gestion de la performance hospitalière. L’étude repose sur un corpus de 183 articles publiés entre 2020 et 2025 et indexés dans la base Web of Science. Les données ont été analysées à l’aide des logiciels Bibliometrix/Biblioshiny et VOSviewer, en mobilisant des indicateurs de production scientifique, de Co-citation, de Co-occurrence des mots-clés et de collaboration internationale. Les résultats mettent en évidence une croissance soutenue des publications à partir de 2023, traduisant un intérêt scientifique croissant pour les dispositifs de financement à l’activité. Ils montrent également une structuration progressive du champ de recherche autour de quelques pôles géographiques et d’auteurs centraux, ainsi qu’une prédominance de thématiques liées à la performance, à l’efficience, à la qualité des soins et à la gouvernance des systèmes de financement hospitalier. L’analyse souligne enfin les tensions persistantes entre incitations économiques, qualité des soins et missions de service public, confirmant le caractère ambivalent de la T2A en tant qu’outil de pilotage de la performance hospitalière.

Contemporary hospital financing reforms have profoundly transformed the mechanisms used to steer the performance of healthcare institutions. Among these reforms, Activity-Based Funding (ABF), grounded in Diagnosis-Related Group (DRG) systems, has progressively emerged as a central regulatory instrument, combining financing logics with management control and performance evaluation mechanisms. This article presents a bibliometric analysis of the international scientific literature addressing ABF/DRG as a tool for hospital performance management. The study is based on a corpus of 183 articles published between 2020 and 2025 and indexed in the Web of Science database. The data were analysed using the Bibliometrix/Biblioshiny and VOSviewer software packages, drawing on indicators of scientific production, co-citation, keyword co-occurrence, and international collaboration. The results reveal a sustained growth in publications since 2023, reflecting a rising scholarly interest in activity-based hospital funding systems. They also highlight a progressive structuring of the research field around a limited number of geographical hubs and central authors, as well as the dominance of themes related to performance, efficiency, quality of care, and the governance of hospital financing systems. Finally, the analysis points to persistent tensions between economic incentives, quality of care, and public service missions, confirming the ambivalent nature of Activity-Based Funding as a hospital performance steering tool.

Keywords

Tarification à l'activité ; Diagnosis-Related Groups ; performance hospitalière ; contrôle de gestion ; Analyse bibliométrique., MCAFER

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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