Introducing activity-based payment in the hospital industry: Evidence from French data

L’introduction de la tarification à l’activité dans les hôpitaux en France

Philippe Choné, Franck Evain, Lionel Wilner and Engin Yilmaz
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Philippe Choné: CREST - Centre de Recherche en Économie et Statistique - ENSAI - Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] - Groupe ENSAE-ENSAI - Groupe des Écoles Nationales d'Économie et Statistique - X - École polytechnique - IP Paris - Institut Polytechnique de Paris - ENSAE Paris - École Nationale de la Statistique et de l'Administration Économique - Groupe ENSAE-ENSAI - Groupe des Écoles Nationales d'Économie et Statistique - IP Paris - Institut Polytechnique de Paris - CNRS - Centre National de la Recherche Scientifique
Franck Evain: DREES - Direction de la recherche, des études, de l’évaluation et des statistiques [Paris] - Ministère des Solidarités et de la Santé [Paris, France]
Engin Yilmaz: DREES - Direction de la recherche, des études, de l’évaluation et des statistiques [Paris] - Ministère des Solidarités et de la Santé [Paris, France]

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Abstract: Many countries have reformed hospital reimbursement policies to provide stronger incentives for quality and cost reduction. The purpose of this work is to show how the effect of such reforms depends on the intensity of local competition. We build a nonprice competition model to examine the effect of a shift from global budget to patient-based payment for public hospitals in France. We predict that the number of patient admissions should increase in public hospitals by more than in private clinics and that the increase in admissions should be stronger in public hospitals that are more exposed to competitive pressure from private clinics. Considering the reform implemented in France between 2005 and 2008, we find empirical evidence supporting these predictions: the activity increased up to 10% in public hospitals more exposed to competitive pressure from private clinics while it hardly raised by 4% in public hospitals less exposed to such a competitive pressure, in comparison with private clinics.

Keywords: Health care markets; prospective payment system; local competition; notfor-profit hospitals; Marché de la santé; tarification prospective à l'activité; concurrence locale; hôpitaux publics (search for similar items in EconPapers)
Date: 2013-09
Note: View the original document on HAL open archive server: https://insee.hal.science/hal-05462613v1
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Working Paper: Introducing Activity-Based Payment in the Hospital Industry: Evidence from French Data (2013)
Working Paper: Introducing activity-based payment in the hospital industry: Evidence from French data (2013)
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