Can General Practitioners Be More Productive? The Impact of Teamwork and Cooperation with Nurses on GP Activities

Christophe Loussouarn, Carine Franc (), Yann Videau () and Julien Mousquès ()
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Christophe Loussouarn: ERUDITE - Equipe de Recherche sur l’Utilisation des Données Individuelles en lien avec la Théorie Economique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12 - Université Gustave Eiffel, IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres
Carine Franc: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres
Yann Videau: ERUDITE - Equipe de Recherche sur l’Utilisation des Données Individuelles en lien avec la Théorie Economique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12 - Université Gustave Eiffel

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Abstract: The integration of primary care organizations and interprofessional cooperation is encouraged in many countries to both improve the productive and allocative efficiency of care provision and address the unequal geographical distribution of general practitioners (GPs). In France, a pilot experiment promoted the vertical integration of and teamwork between GPs and nurses. This pilot experiment relied on the staffing and training of nurses; skill mixing, including the authorization to shift tasks from GPs to nurses; and new remuneration schemes. This article evaluates the overall impact of this pilot experiment over the period 2010–2017 on GP activities based on the following indicators: number of working days, patients seen at least once, patients registered, and visits delivered. We control for endogeneity and reduce selection bias by using a case-control design combining coarsened exact matching and difference-in-differences estimates on panel data. We find a small positive impact on the number of GP working days (+1.2%) following enrollment and a more pronounced effect on the number of patients seen (+7.55%) or registered (+6.87%). However, we find no effect on the number of office and home visits. In this context, cooperation and teamwork between GPs and nurses seem to improve access to care for patients.

Keywords: cooperation between general practitioners and nurses; difference-in-differences; labor supply; panel data (search for similar items in EconPapers)
Date: 2021
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Published in Health Economics, 2021, 30 (3), pp.680-698. ⟨10.1002/hec.4214⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03171227

DOI: 10.1002/hec.4214

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