Gatekeeping and the utilization of physician services in France: Evidence on the Médecin traitant reform

Dumontet, Magali; Buchmueller, Thomas C.; Dourgnon, Paul; Jusot, Florence; Wittwer, Jérôme

doi:10.1016/j.healthpol.2017.04.006

Cited by 23 publications

(15 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Проблемы перехода к модели диспетчера в здравоохранении В Германии повышение тарифов привело к росту совокупного объема расходов на душу населения [6], во Франции -к снижению ожидаемой экономии [9].…”

Section: финансы социальной сферыunclassified

“…За первые годы реализации реформы отдельным врачам удалось повысить доход более чем на 60 %, что стало важным аргументом в пользу прекращения реформы [7]. Полностью свободный доступ к специализированной медицинской помощи сохраняется для детей, ограниченный доступ -к психиатрам (для лиц до 25 лет), офтальмологам (только для подбора очков) и гинекологам (только для подбора контрацепции, ведения беременности и ранней диагностики рака) [9].…”

Section: франция (1998-2005 гг)unclassified

“…Среди лиц, осуществивших выбор, 81 % опрошенных указали в числе причин восприятие выбора как обязательного, 44 % -опасение штрафных санкций и лишь 16 % -возможность улучшения качества медицинской помощи [7]. К 2008 г. охват моделью диспетчера достиг 85,8 % [9].…”

Section: франция (1998-2005 гг)unclassified

“…снизились на 2 %. Эффект дальнейшего сокращения числа посещений оказался поглощен повышением стоимости услуг врачейспециалистов [9]. В ходе первоначального этапа реформы доход врачей-специалистов сократился на 2,2-5,6 % в зависимости от специальности, но уже в 2006 г. было принято решение о повышении тарифов для областей специализированной медицинской помощи с наибольшим сокращением потребления (реабилитационная помощь, дерматология, эндокринология, ревматология, оториноларингология и терапия внутренних болезней).…”

Section: франция (1998-2005 гг)unclassified

See 3 more Smart Citations

Problems of Transition to a Gatekeeper Model in Healthcare

Sisigina¹

2018

View full text Add to dashboard Cite

Regulation of access to specialist medical care is widely viewed as effective tool for health cost containment. However, the results of the access reforms in well-developed public health systems in practice are often below the expected level. The article provides an overview of structure and outcomes of major national access reform programmes in European countries. Based on the collected data key determinants of successful adoption of gatekeeping model were highlighted in the article. The author proposes the promising ways of the development of the current access model reform in Russia.

show abstract

Section: финансы социальной сферыunclassified

Section: франция (1998-2005 гг)unclassified

See 2 more Smart Citations

Problems of Transition to a Gatekeeper Model in Healthcare

Sisigina¹

2018

View full text Add to dashboard Cite

show abstract

“…Since 2005, GPs have been given a soft gatekeeper role. Patients must designate a médecin traitant, who is a GP in the vast majority of cases [ 16 , 17 , 18 ]. Said GP will be their first point of contact with the health care system.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Determinants of Polypharmacy Prescribing and Dispensing Behaviours in Primary Care for the Elderly—Protocol for a Qualitative Study

Taghy

Cambon

Boulliat

et al. 2021

IJERPH

View full text Add to dashboard Cite

Polypharmacy is becoming increasingly common, especially among the elderly. It often has a negative connotation, but is sometimes necessary or even desirable, and needed to categorize polypharmacy as appropriate or inappropriate. The challenge is in ensuring that this is considered appropriate when necessary. We aimed to develop an evidence-based intervention to reduce the risks associated with using a systematic approach, involving key stakeholders in prescribing and dispensing drugs to the elderly in primary care. The purpose of this study is to identify the key components which are perceived as influencing these behaviours. It is a qualitative study of general practitioners (GPS) and community pharmacists involved in the care of the elderly. The main inclusion criterion is the geographic location. Qualitative data will be generated from one-on-one, semi-structured interviews and processed for thematic content analysis. Our approach integrates the patient pathway in primary care. It considers the fact that GP and pharmacist behaviours are far from being independent. This study represents the first step in the process of developing an intervention theory which involves a crossover between data from the literature and the knowledge of experts, allowing us to interrogate hypotheses about the influences and mechanisms associated with prescribing and dispensing drugs to the elderly in primary care.

show abstract

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

et al. 2020

View full text Add to dashboard Cite

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-indifferences estimates on panel data. We find a small positive impact on the number of GP working days (þ1.2%) following enrollment and a more pronounced effect on the number of patients seen (þ7.55%) or registered (þ6.87%). 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.

show abstract

Gatekeeping and the utilization of physician services in France: Evidence on the Médecin traitant reform

Cited by 23 publications

References 11 publications

Problems of Transition to a Gatekeeper Model in Healthcare

Problems of Transition to a Gatekeeper Model in Healthcare

Exploring the Determinants of Polypharmacy Prescribing and Dispensing Behaviours in Primary Care for the Elderly—Protocol for a Qualitative Study

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

Contact Info

Product

Resources

About