Impacts des incitatifs économiques en médecine générale: Analyse des préférences et des motivations des médecins

Jonathan Sicsic

in Economics Thesis from University Paris Dauphine from Paris Dauphine University

Abstract: This thesis addresses several issues raised by the introduction in France of economic incentives such as pay-For-Performance applied to general practice. These incentive schemes are designed to improve the quality of care, but they are discussed both in terms of effectiveness and potential side effects. Initially, we assess the impact of the CAPI scheme on various indicators of quality of care: the consultation length and cancers screening. Then, using the discrete choice experiment methodology, we reveal general practitioners (GPs) preferences for devices aimed at improving the early detection of cancers. Finally, we analyse empirically the relationship between French GPs' intrinsic and extrinsic motivations. We show that the CAPI has not had a significant impact on the selected quality indicators. In addition, GPs would be sensitive to potentially less costly nonmonetary devices. Eventually, we highlight a negative relationship between GPs' intrinsic and extrinsic motivations. Our results call for greater caution in the definition of economic incentives in general practice.

Keywords: Dépistage des cancers; Économie de la santé; Incitatifs économiques; Médecine générale; Méthodologie des choix discrets; Motivations intrinsèques; Paiements à la performance; Révélation des préférences; Cancer screening; Health economics; Economic incentives; General practice; Discrete choice experiment; Intrinsic motivations; Pay-For-Performance; Stated preferences (search for similar items in EconPapers)
JEL-codes: I11 I18 (search for similar items in EconPapers)
Date: 2014 Written 2014
Note: dissertation
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