Standard&Poor's Ratings Services has affirmed its 'AAA' long-term issuer credit rating on French public hospital group Assistance Publique - Hôpitaux de Paris (AP-HP). The outlook is stable. The rating reflects AP-HP's strong state support, its specific and ongoing direct supervision by the central government due to its social importance, its systemic weight in France's health care budget, and its national flagship role for medical education and research. The rating also reflects AP-HP's strong business profile as Europe's largest hospital group, representing about 50% of Paris' and 30% of Ile-de-France's hospital capacity and activity. Following the gradual change to an output-oriented financing system from an expenditure-driven one, variable revenues have accounted for about 70% of the group's total revenues
