From care of the poor to the great confinement: an exploration of hospital accounting in France

Abstract

This study examines hospital accounting practices in France during the fifteenth through seventeenth centuries in order to illustrate differences between the role and mission of the Hôtel-Dieu and the Hôpital Général. The Hôtel-Dieu originated during the medieval period as a place of refuge for the sick and the poor, whereas the Hôpital Général was created during the seventeenth century as a way of resolving problems associated with a growing population of beggars and vagrants in French cities. The accounting records of the Hôtel-Dieu appear to follow the charge-and-discharge system of accounting similar to that employed by ecclesiastical and governmental institutions of the same time period. Although the accounts of the Hôpital Général also followed the charge-and-discharge system, those accounts appear to have been prepared with the direct authority of a Treasurer operating under a Board of Commissioners appointed by the King, thus indicating a greater emphasis on internal control. The similarity in accounting practices for two very different types of institutional structures suggests that accounting practices do not necessarily change as a result of institutional changes. In other words, there may be a break in institutional form without a corresponding break in accounting practices.