IDEAS home Printed from https://ideas.repec.org/a/adr/anecst/y2005i79-80p697-726.html
   My bibliography  Save this article

Innovation Diffusion under Budget Constraints: Microeconometric Evidence on Heart Attack in France

Author

Listed:
  • Brigitte Dormont
  • Carine Milcent

Abstract

We study the diffusion of innovative procedures for heart attack treatment, focusing on its impact on the distributions of the cost and length of hospital stays. We perform microsimulations on a sample of 5,681 stays in French public hospitals to evaluate the impacts of adoption of new techniques by hospitals, dissemination of new techniques within hospitals, and changes in patients' characteristics. Between 1994 and 1997, French public hospitals faced two main causes of rise in costs: diffusion of innovative procedures and a worsening of patients' state. However, they were financed by a global budget, and their budgets increased very slowly. We show that they deal with their financial constraints by reducing greatly the length of stays for patients at the bottom of the distribution. This appears to have enabled hospitals to finance the diffusion of angioplasty. Obviously, such a strategy cannot be sustained in the long run without jeopardizing the quality of care.

Suggested Citation

  • Brigitte Dormont & Carine Milcent, 2005. "Innovation Diffusion under Budget Constraints: Microeconometric Evidence on Heart Attack in France," Annals of Economics and Statistics, GENES, issue 79-80, pages 697-726.
  • Handle: RePEc:adr:anecst:y:2005:i:79-80:p:697-726
    as

    Download full text from publisher

    File URL: http://www.jstor.org/stable/20777593
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Van de Ven, Wynand P. M. M. & Van Praag, Bernard M. S., 1981. "The demand for deductibles in private health insurance : A probit model with sample selection," Journal of Econometrics, Elsevier, vol. 17(2), pages 229-252, November.
    2. Juhn, Chinhui & Murphy, Kevin M & Pierce, Brooks, 1993. "Wage Inequality and the Rise in Returns to Skill," Journal of Political Economy, University of Chicago Press, vol. 101(3), pages 410-442, June.
    3. F. Bourguignon & M. Fournier & M. Gurgand, 2001. "Fast Development With a Stable Income Distribution: Taiwan, 1979–94," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 47(2), pages 139-163, June.
    4. repec:bla:revinw:v:47:y:2001:i:2:p:139-63 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth: reassessing the threat of ageing," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 947-963, September.
    2. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," Journal of Economic Geography, Oxford University Press, vol. 13(6), pages 1013-1040, November.
    3. Carine Milcent, 2021. "Competition in French hospital: Does it impact the patient management in healthcare?," Working Papers halshs-03152752, HAL.
    4. Carine Milcent, 2021. "Competition in French hospital: Does it impact the patient management in healthcare?," Working Papers halshs-03152752, HAL.
    5. Laurent Gobillon & Carine Milcent, 2008. "Regional disparities in mortality by heart attack: evidence from France," PSE Working Papers halshs-00586837, HAL.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Utpal Kumar De & Loitongbam Hena Devi, 2023. "Inequality Dynamics in Urban Manipur, India: A Decomposition Analysis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 167(1), pages 67-89, June.
    2. Ebo Botchway & Kofi Fred Asiedu, 2020. "Ownership type and earnings gap decomposition: Evidence from the Ghanaian labor market," African Development Review, African Development Bank, vol. 32(4), pages 619-631, December.
    3. repec:dau:papers:123456789/5430 is not listed on IDEAS
    4. Mulubrhan Amare & Bekele Shiferaw & Hiroyuki Takeshima & George Mavrotas, 2021. "Variability in agricultural productivity and rural household consumption inequality: Evidence from Nigeria and Uganda," Agricultural Economics, International Association of Agricultural Economists, vol. 52(1), pages 19-36, January.
    5. P.N. (Raja) Junankar & Stéphane Mahuteau, 2005. "Do Migrants Get Good Jobs? New Migrant Settlement in Australia," The Economic Record, The Economic Society of Australia, vol. 81(s1), pages 34-46, August.
    6. Hartarska, Valentina M. & Nadolnyak, Denis A., 2012. "Financing Constraints and Access to Credit in Post Crisis Environment: Evidence from New Farmers in Alabama," 2012 Annual Meeting, August 12-14, 2012, Seattle, Washington 124882, Agricultural and Applied Economics Association.
    7. Evenson, Robert E. & Kimhi, Ayal & Desilva, Sanjaya, 2000. "Supervision And Transaction Costs: Evidence From Rice Farms In Bicol, The Philippines," 2000 Annual meeting, July 30-August 2, Tampa, FL 21788, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    8. Stephen J. Trejo, 2003. "Intergenerational Progress of Mexican-Origin Workers in the U.S. Labor Market," Journal of Human Resources, University of Wisconsin Press, vol. 38(3).
    9. Jae Song & David J Price & Fatih Guvenen & Nicholas Bloom & Till von Wachter, 2019. "Firming Up Inequality," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 1-50.
    10. Sarah Bridges & David Lawson, 2008. "Health and Labour Market Participation in Uganda," WIDER Working Paper Series DP2008-07, World Institute for Development Economic Research (UNU-WIDER).
    11. Joanna Tyrowicz & Lucas van der Velde, 2017. "When the opportunity knocks: large structural shocks and gender wage gaps," GRAPE Working Papers 2, GRAPE Group for Research in Applied Economics.
    12. Giuseppe Croce & Emanuela Ghignoni, 2011. "Overeducation and spatial flexibility in Italian local labour markets," Working Papers in Public Economics 145, Department of Economics and Law, Sapienza University of Roma.
    13. Brown, Philip & Roper, Simon, 2017. "Innovation and networks in New Zealand farming," Australian Journal of Agricultural and Resource Economics, Australian Agricultural and Resource Economics Society, vol. 61(3), July.
    14. Naila Kabeer & Lopita Huq & Muhammad Mahabub Rahaman, 2021. "Material barriers, cultural boundaries: A mixed-methods analysis of gender and labour market segmentation in Bangladesh," WIDER Working Paper Series wp-2021-69, World Institute for Development Economic Research (UNU-WIDER).
    15. Coral del Río Otero & Carlos Gradín Lago & Olga Cantó Sánchez, 2004. "El enfoque distributivo en el análisis de la discriminación salarial por razón de género," Working Papers 0405, Universidade de Vigo, Departamento de Economía Aplicada.
    16. Husain, Zakir & Ghosh, Saswata & Dutta, Mousumi, 2022. "Changes in dietary practices of mother and child during the COVID-19 lockdown: Results from a household survey in Bihar, India," Food Policy, Elsevier, vol. 112(C).
    17. repec:spo:wpecon:info:hdl:2441/eu4vqp9ompqllr09i8hjg0kpi is not listed on IDEAS
    18. Fossen, Frank M. & König, Johannes, 2015. "Public health insurance and entry into self-employment," VfS Annual Conference 2015 (Muenster): Economic Development - Theory and Policy 112934, Verein für Socialpolitik / German Economic Association.
    19. Zsófia L. Bárány, 2016. "The Minimum Wage and Inequality: The Effects of Education and Technology," Journal of Labor Economics, University of Chicago Press, vol. 34(1), pages 237-274.
    20. Osei-Tutu, Francis & Weill, Laurent, 2023. "Individualism reduces borrower discouragement," Journal of Economic Behavior & Organization, Elsevier, vol. 211(C), pages 370-385.
    21. Richard Jackman & Richard Layard & Marco Manacorda & Barbara Petrongolo, 1997. "European versus US Unemployment: Different Responses to Increased Demand for skill?," CEP Discussion Papers dp0349, Centre for Economic Performance, LSE.
    22. Hunt, Jennifer & Laszlo, Sonia, 2005. "Bribery: Who Pays, Who Refuses, What are the Payoffs?," CEPR Discussion Papers 5251, C.E.P.R. Discussion Papers.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:adr:anecst:y:2005:i:79-80:p:697-726. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Secretariat General or Laurent Linnemer (email available below). General contact details of provider: https://edirc.repec.org/data/ensaefr.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.