Show simple item record

dc.contributor.authorDourgnon, Paul
dc.contributor.authorNaiditch, Michel
dc.date.accessioned2013-12-03T09:23:10Z
dc.date.available2013-12-03T09:23:10Z
dc.date.issued2010
dc.identifier.urihttps://basepub.dauphine.fr/handle/123456789/12227
dc.language.isoenen
dc.subjectManaged Careen
dc.subjecthealth care services utilizationen
dc.subjectunmet needsen
dc.subjectHealth care reformen
dc.subjectGate-keepingen
dc.subjectEvaluation studiesen
dc.subject.ddc334en
dc.subject.classificationjelI18en
dc.titleThe preferred doctor scheme: A political reading of a French experiment of Gate-keepingen
dc.typeArticle accepté pour publication ou publié
dc.description.abstractenObjectives Since 2006 France experiences an innovative version of Gate-keeping which aims at regulating access to outpatient specialist care. We describe the reform's initial objectives, the political pathway which lead to the implementation of a reshaped reform and discuss the first outcomes after 1 year implementation. In the conclusion, we try to catch a glimpse for future steps of the reform. Methods In order to observe the implantation and impact on the reform, we used national sickness fund databases and a sample of 7198 individuals from the 2006 French Health, Health Care and Insurance Survey (ESPS), including health, socio-economic and insurance status, questions relating to patient's understanding and compliance with the scheme, self-assessed unmet specialist needs since the reform. Results and discussion 2006 results show that 94% chose a preferred doctor, in a vast majority their family doctor. Impact on access to specialist care appears significant for the less well off and those not covered by a complementary insurance. From the specialist's side, new constraints on access to care seem to have been offset by rises in fee schedules. Conclusion Notwithstanding disappointing short terms results, the new scheme may however lead up to reinforced managed care reforms.en
dc.relation.isversionofjnlnameHealth Policy
dc.relation.isversionofjnlvol94en
dc.relation.isversionofjnlissue2en
dc.relation.isversionofjnldate2010
dc.relation.isversionofjnlpages129-134en
dc.relation.isversionofdoihttp://dx.doi.org/10.1016/j.healthpol.2009.09.001en
dc.relation.isversionofjnlpublisherElsevieren
dc.subject.ddclabelEconomie socialeen
dc.relation.forthcomingnonen
dc.relation.forthcomingprintnonen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record