IDEAS home Printed from https://ideas.repec.org/a/cai/recosp/reco_602_0457.html
   My bibliography  Save this article

Les hôpitaux français face au paiement prospectif au cas. La mise en œuvre de la tarification à l'activité

Author

Listed:
  • Gérard de Pouvourville

Abstract

Since 2004, French public and private hospitals are submitted to a prospective per-case based payment system based on a drg like classification scheme. A comparative analysis with the Medicare prospective payment scheme shows that the implementation of the so-called Activity Based Payment Scheme (T2A) is embedded in a national expenditure cap and planning regulations which restrict the strategic autonomy of providers. Moreover, the system blends retrospective and prospective elements which limit the incentive to reduce unit costs. Altogether, the French model is closer to regulation with fixed rates under planning constraints than to the initial "yardstick competition model" that was implemented by Medicare in the usa. The consequences of the French model on resource allocation are then discussed using a selection of theoretical and empirical contributions on the incentive effects of prospective per case payment. Classification JEL : I18

Suggested Citation

  • Gérard de Pouvourville, 2009. "Les hôpitaux français face au paiement prospectif au cas. La mise en œuvre de la tarification à l'activité," Revue économique, Presses de Sciences-Po, vol. 60(2), pages 457-470.
    • Handle: RePEc:cai:recosp:reco_602_0457
    as

    Download full text from publisher

    File URL: http://www.cairn.info/load_pdf.php?ID_ARTICLE=RECO_602_0457
    Download Restriction: free
    File URL: http://www.cairn.info/revue-economique-2009-2-page-457.htm
    Download Restriction: free
    ---><---

    Citations

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


    Cited by:

    1. Jane Despatin & Michel Nakhla & Eric Wable & Yves Auroy, 2015. "Public Performance And Simulation: A Case Study In The French Military Health Service," Post-Print hal-01158733, HAL.
    2. Bonastre, Julia & Chevalier, Julie & Van der Laan, Chantal & Delibes, Michel & De Pouvourville, Gerard, 2014. "Access to innovation: Is there a difference in the use of expensive anticancer drugs between French hospitals?," Health Policy, Elsevier, vol. 116(2), pages 162-169.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    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:cai:recosp:reco_602_0457. 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.

    We have no bibliographic references for this item. You can help adding them by using 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: Jean-Baptiste de Vathaire (email available below). General contact details of provider: https://www.cairn.info/revue-economique.htm .

    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.