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The link between medical performance and composition of patient base: An econometric study of Ile-de-France doctors

Les liens entre la performance médicale et la composition de la patientèle: une étude économétrique sur les médecins d’Ile de France

Nicolas Da Silva (), Laetitia Fleury, Philippe Batifoulier (), Jean-Louis Vanhille and Pierre-Henri Bréchat
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Laetitia Fleury: Service médical d’assurance maladie [Ile-de-France]
Jean-Louis Vanhille: Service médical d’assurance maladie [Ile-de-France]
Pierre-Henri Bréchat: IDS - U1145 - Institut Droit et Santé - UPD5 - Université Paris Descartes - Paris 5 - INSERM - Institut National de la Santé et de la Recherche Médicale

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Abstract: The medical convention signed in 2011 introduced a pay-for-performance (P4P) mechanism in medical compensation : in P4P. Doctors receive monetary incentives for achieving targets on predefined performance measures – in terms of quality of care and financial savings. The aim of this paper is to assess the French P4P with an original study on Ile-de-France physicians. We test the hypothesis that medical performance is partly dependant on composition of patient base – performance is then partly independent of his implication and responsibility. Our results show that doctors having more sick patients have more chances to obtain a good performance. Furthermore, doctors having more poor patients have fewer chances to obtain a good performance.

Date: 2015
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Published in Journal de Gestion et d’Économie Médicales, Editions ESKA, 2015, 33, pp.191-214. ⟨10.3917/jgem.153.0191⟩

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DOI: 10.3917/jgem.153.0191

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