General Practitioners activity patterns: the medium-term impacts of Primary Care Teams in France

Matthieu Cassou (), Julien Mousquès () and Carine Franc ()
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Matthieu Cassou: IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres
Julien Mousquès: IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, ARENES - Arènes: politique, santé publique, environnement, médias - UR - Université de Rennes - Institut d'Études Politiques [IEP] - Rennes - EHESP - École des Hautes Études en Santé Publique [EHESP] - UR2 - Université de Rennes 2 - CNRS - Centre National de la Recherche Scientifique, RSMS - Recherche sur les services et le management en santé - UR - Université de Rennes - EHESP - École des Hautes Études en Santé Publique [EHESP] - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique, EHESP - École des Hautes Études en Santé Publique [EHESP], SHS - Département des sciences humaines et sociales - EHESP - École des Hautes Études en Santé Publique [EHESP]
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

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Abstract: Faced with the fragmentation of the French primary care system, public policies aim to promote multiprofessional teamwork to improve both delivery efficiency and health professionals' working conditions. Thus, a practice-level add-on payment backed by cooperation commitments is implemented to foster and sustain the development of multiprofessional primary care groups (MPCGs). We study the impact of practising in MPCGs for general practitioners (GPs) in terms of the supply of care, practice patterns and income. Based on this quasiexperimental framework with a panel dataset covering the period 2005-2017, we account for the selection into MPCGs by combining a difference-in-differences design with propensity score matching to prebalance samples. We show that GPs in MPCGs increased their patient list more rapidly than control GPs (+10% increase of encountered patients) without increasing their provision of services (number of visits and drug prescriptions) more rapidly. Instead, compared to control GPs, MPCG GPs had a significantly faster reduction in the average number of visits (+5.5% reduction) and the euro-amounts of drug prescriptions per patient (+7.2% reduction) and other prescriptions. The growth of these effects between the short and medium term moreover suggests that the properties of multi-professional coordination and cooperation need time to develop.

Keywords: Primary Care; General Practitioner; Care and services; Teamwork; Difference-in-differences; Panel; Data (search for similar items in EconPapers)
Date: 2023-10
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Citations: View citations in EconPapers (2)

Published in Health Policy, 2023, 136, pp.104868. ⟨10.1016/j.healthpol.2023.104868⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04228634

DOI: 10.1016/j.healthpol.2023.104868

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