Soins primaires et performance: de la variabilité des pratiques des médecins généralistes au rôle de l'organisation des soins

Julien Mousquès ()

in Economics Thesis from University Paris Dauphine from Paris Dauphine University

Abstract: According to economic research, the general practitioner is considered as an agent that offered information and intellectual services in health to principals. Imperfect convergence between their objectives, like the presence of uncertainties and information asymmetries, lead the physician “to fix” the quantities, the effort and the quality of the care and services delivered. Based on three articles, this thesis aims at identifying the role of the characteristics of the general practitioners and of their practice organization, on activity performance. The first articles analyzes the determinants of the antibiotic prescription for acute rhinopharyngitis variability, the second evaluates the impact of team working with nurses on the quality and the efficiency of the care for diabetic patients, and the third evaluates the impact of multi-professional group practices on the activity and the productive efficiency of GPs and on the utilization of ambulatory health care and by their patients. These researches question the relative weakness of the ambulatory health care regulation in France in terms of health care expenditure containment policies in comparison with that bearing on demand.

Keywords: Médecin généraliste; Variation des pratiques médicales; Travail en équipe; Exercice en groupe; Intégration verticale; Evaluation des résultats et processus; Consommation de soins; Expérimentation naturelle; Evaluation des politiques publiques; General practitioners; Medical practice variation; Team working; Group practicing; Vertical integration; Outcome and process assessment; Health care utilization; Natural experiment; Policy evaluation (search for similar items in EconPapers)
JEL-codes: I18 I38 (search for similar items in EconPapers)
Date: 2014 Written 2014
Note: dissertation
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