[Evaluation and decision. The decision maker's point of veiw. Results of a study in Quebec (author's transl)].

In Quebec, from 1967 to 1970, a Commission on Health and Social Services studied the health system and recommended drastic changes in its organization. The evaluation of the health system process is briefly reviewed and three specific problems are used to illustrate the role of evaluation in the decision making process; these problems are the evolution of the number of general practitioners, the number of hospital beds by categories from 1970 to 1977 and the growth of health expenditures. In the second part, I use a health index, infantile mortality, to show the advantages of evaluating the health status of the population in the formulation of policies. In Quebec, from 1970 to 1977, after the implantation of a policy on perinatality by the Ministry, the infant mortality rate by 1,000 living births decreased from 20.6 to 12.4. The factors responsible for that improvement are analyzed and discussed.