The rating reflects Assistance Publique-Hôpitaux de Paris' (AP-HP): Importance in the provision of health care services in France and abroad; Close financial ties with the French state, which maintains considerable financial and operational control over the entity; and Stable revenues, which are derived mainly from the national social-security system. Thanks to this revenue stability, AP-HP consistently records satisfactory financial performance and has a low level of debt by national and international standards. With 40 hospitals, AP-HP is Europe's largest public-hospital organization, in addition to being a major teaching and research center. Given its size and strategic importance, AP-HP enjoys a special status and has very close links with the central government. The organization is directly supervised by several state ministries,
