Le panel de médecins généralistes de ville : éclairages sur les enjeux de la médecine de premier recours d’aujourd’hui

Verger, Pierre; Bocquier, Aurélie; Bournot, Marie-Christine; Buyck, Jean-François; Carrier, Hélène; Chaput, Hélène; Giraud, Julien; Hérault, Thomas; Filippi, Simon; Marbot, Claire; Rey, D.; Tallec, A.; Zaytseva, Anna; Ventelou, Bruno

doi:10.3917/rfas.173.0213

Cited by 2 publications

(2 citation statements)

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“…These trends should particularly modify the content and organization of the PHC supply. In addition, the share of the time spent with patients in total GP working time is quite low (70%) and has been decreasing over time (Verger et al., 2017). All this could exacerbate the growing inequalities in access to PHC (Vergier, Chaput, & Lefebvre‐Hoang, 2017) and complicate their description (Chevillard, & Mousquès, 2018).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…En conséquence de ces évolutions démographiques, se pose le problème, plutôt bien documenté, du creusement des inégalités géographiques d'accès aux soins (Vernier et Chaput, 2017) et des façons de les décrire (Chevillard, 2018). En parallèle, la relative faiblesse du temps médical rapporté au temps de travail total des MG (de l'ordre de 70 %) [Verger et al, 2017] et la tendance à la dégradation de ce ratio offrent pourtant des leviers d'augmentation de ce temps médical disponible (Bras, 2011). Face à la baisse de l'offre de travail des MG et de leur temps directement dédié aux patients, de 8 Document de travail n° 77 -Irdes -Avril 2019 Impact de l'expérimentation de coopération entre médecin généraliste et infirmière Asalée sur l'activité des médecins nombreux pays de l'Organisation de coopération et de développement économiques (OCDE) ont favorisé l'intégration des systèmes de soins primaires, la coopération interprofessionnelle et la délégation des tâches entre les médecins et les autres professionnels de santé afin d'améliorer l'efficience de l'offre de soins (Delamaire et Lafortune, 2010 ;Groenewegen et al 2015 ;de Bont et al 2016).…”

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Impact de l’expérimentation de coopération entre médecin généraliste et infirmière Asalée sur l’activité des médecins

Loussouarn¹,

Franc²,

Videau³

et al. 2019

Revue d'Économie Politique

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In many countries, policies have explicitly encouraged the integration of primary care organisations and interprofessional cooperation to improve the productive and allocative efficiency of care provision and to address the unequal geographical distribution of physicians. In France, the Social Security Department of the Ministry of Health (DSS) and a not-for-profit organisation called Asalee ("Action de sante libérale en équipe" meaning Teamwork in self-employed medical practice) set up an experiment to promote vertical integration and teamwork between general practitioners and nurses, notably based on nurses' staffing and training as well as authorisation of task substitution between general practitioners and nurses and new remuneration schemes. This article evaluates the extension of this experiment over the period 2010-2016 by studying the joint effect of the cooperation between general practitioners and nurses, the specific organization of Asalee and the underlying economic incentives on general practitioners' activity based on the following: number of working days, patients seen at least once or listed and visits delivered (office and/or home). We control, as much as possible, for endogeneity and reduce selection biases by using a case-control design, using exact matching method and difference-indifferences estimation methods on panel data. We highlight a positive but relatively modest effect of entering into the Asalee pilot on the number of GPs' working days (+1.2%) and a more pronounced effect on the number of patients seen (+7.55%) or listed (+6.87%). Yet, we find no effect on the number of office and home visits.

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Le panel de médecins généralistes de ville : éclairages sur les enjeux de la médecine de premier recours d’aujourd’hui

Cited by 2 publications

References 20 publications

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

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

Impact de l’expérimentation de coopération entre médecin généraliste et infirmière Asalée sur l’activité des médecins

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