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Concurrence, prix et qualité de la prise en charge en EHPAD en France : Analyses micro-économétriques

Editor

Listed:
  • Dormont, Brigitte

Author

Listed:
  • Martin, Cécile

Abstract

High prices and insufficient quality of care are observed in nursing homes in France. Reforms are currently under discussion, but governments are facing a dilemma : any measure of price cut is likely to affect quality and any improvement in quality would probably be inflationary. This work analyzes if this dilemma can be solved by focusing more particularly on the potential effect of real and yardstick competition that could be introduced in this long term care sector. Using a micro-econometric framework, we organize this analysis into three research issues : (i) What might be expected from the pricing reform and the increase in the number of beds in nursing homes currently proposed ? (ii) How the development of for-profit nursing homes could reduce prices and improve quality ? (iii) Are there local difficulties responsible for the poor quality of nursing homes ? Several implications for public policy may be involved. Using cost frontier estimates, we demonstrate that the reform plans would reduce inefficiency and nursing home prices, but at the expense of their quality. The rise of for-profit nursing homes leads to high prices and a deterioration of the quality of care which could be tempered however by a more competitive market structure. Nursing homes face local difficulties in nursing staff retention, affecting their quality and which do not seem to be solved by adjusting wages.

Suggested Citation

  • Martin, Cécile, 2014. "Concurrence, prix et qualité de la prise en charge en EHPAD en France : Analyses micro-économétriques," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13712 edited by Dormont, Brigitte.
    • Handle: RePEc:dau:thesis:123456789/13712
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    References listed on IDEAS

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    Cited by:

    1. Marie‐Louise Leroux & Gregory Ponthiere, 2020. "Nursing home choice, family bargaining, and optimal policy in a Hotelling economy," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(4), pages 899-932, August.
    2. Cécile Martin & Tiphaine Jérôme, 2016. "Cost (In)Efficiency and Institutional Pressures in Nursing Home Chains," European Accounting Review, Taylor & Francis Journals, vol. 25(4), pages 687-718, October.

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    More about this item

    Keywords

    Dépendance; Etablissement d’hébergement pour personnes âgées dépendantes; Efficacité; Qualité des soins; Concurrence; Econométrie; Economie de la santé; Dependence; Nursing homes; Efficiency; Quality of care; Competition; Econometrics; Health economics;
    All these keywords.

    JEL classification:

    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms
    • L10 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models

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