| Titre | Induction de la demande de soins par les médecins libéraux français. Étude micro-économétrique sur données de panel | |
|---|---|---|
| Auteur | Brigitte Dormont, Éric Delattre | |
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Revue | Economie et prévision |
| Numéro | no 142, 2000/1 | |
| Rubrique / Thématique | Comportements stratégiques dans le systèmes de soins |
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| Page | 137-161 | |
| Résumé anglais |
Health Care Demand Induced by French Self-Employed Doctors. A Microeconometric Study Based on Panel Data by Eric Delattre et Brigitte Dormont
A much-debated hypothesis in health economics is the supply-induced demand hypothesis (SID), which posits that suppliers can manipulate demand for their services. This article tests for the existence of SID behaviour using unbalanced panel data covering 7,925 French self-employed Sector 1 and Sector 2 GPs and specialised doctors from 1979 to 1993. These data are representative of the population in question. Estimates provide strong evidence of SID behaviour in Sector 1. Such behaviour entails self-employed doctors restricting the rationing in the number of doctor-patient consultations to which they are subject when doctor density increases and offsetting this phenomenon by raising the volume of care provided per consultation. In Sector 2 (where doctors freely set their fees), doctors' reactions to density variations are compatible with the absence of SID behaviour. An increase in doctor density in Sector 2 brings about a drop in fees and an increase in activity. These reactions are consistent with the predictions of a monopolistic competition model of health care supply. To conclude, we find that a rise in doctor density brings about a rise in the volume of health care supplied in both Sector 1 and Sector 2. In addition, the fee reductions observed in Sector 2 do not help balance the social security system accounts, since these reductions only concern surcharges. Lastly, we establish that our estimated microeconomic elasticities create a massive macroeconomic drift in health care consumption, related to the increase in the number of doctors. Source : Éditeur (via Persée) |
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| Article en ligne | http://www.persee.fr/web/revues/home/prescript/article/ecop_0249-4744_2000_num_142_1_5993 |
