How French general practitioners respond to declining medical density: a study on prescription practices, with an insight into opioids use

Julien Silhol, Bruno Ventelou and Anna Zaytseva
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Julien Silhol: INSEE - Institut national de la statistique et des études économiques (INSEE), AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique

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Abstract: Disparities in physicians' geographical distribution lead to highly unequal access to healthcare, which may impact quality of care in both high and low-income countries. This paper uses a 2013-2014 nationally representative survey of French general practitioners (GPs) matched with corresponding administrative data to analyze the effects of practicing in an area with weaker medical density. To avoid the endogeneity issue on physicians' choice of the location, we enriched our variable of interest, practicing in a relatively underserved area, with considering changes in medical density between 2007 and 2013, thus isolating GPs who only recently experienced a density decline (identifying assumption). We find that GPs practicing in underserved areas do shorter consultations and tend to substitute time-consuming procedures with alternatives requiring fewer human resources, especially for pain management. Results are robust to considering only GPs newly exposed to low medical density. Findings suggest a significant impact of supply-side shortages on the mix of healthcare services used to treat patients, and point to a plausible increased use of painkillers, opioids in particular.

Keywords: prescriptions; general practitioners; medically underserved area; health workforce; opioids; France (search for similar items in EconPapers)
Date: 2020-12
Note: View the original document on HAL open archive server: https://amu.hal.science/hal-02944339v1
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Published in European Journal of Health Economics, 2020, 21 (9), pp.1391-1398. ⟨10.1007/s10198-020-01222-8⟩

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Journal Article: How French general practitioners respond to declining medical density: a study on prescription practices, with an insight into opioids use (2020)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02944339

DOI: 10.1007/s10198-020-01222-8

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