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Induction de la demande de soins par les médecins libéraux français. Etude microéconométrique sur données de panel

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  • E Delattre
  • B. Dormont

Abstract

[fre] Cette étude a pour objet d'analyser les comportements d'offre de soins des médecins libéraux français. On dispose pour cela d'un panel non cylindre de 7 925 médecins omnipraticiens ou spécialistes, des secteurs 1 ou 2, suivis sur la période 1979-1993 et représentatif de la population concernée. Les estimations mettent en évidence l'existence de comportements de demande induite indéniables dans le secteur 1 . Ces comportements permettent aux médecins de limiter les rationnements qu'ils subissent sur le nombre de rencontres médecin-patient quand la densité médicale augmente, et de les compenser par une augmentation du volume de soins fournis au cours de chaque rencontre. Dans le secteur 2 (à honoraires libres), la réaction des médecins aux variations de la densité est compatible avec une absence de comportements d'induction. En effet, une élévation de la densité médicale conduit dans ce secteur à une baisse des tarifs et à une augmentation de l'activité, réactions conformes aux prédictions d'un modèle d'offre de soins basé sur l'hypothèse de concurrence monopolistique. Au total, on constate qu'une augmentation de la densité entraîne une hausse des quantités de soins fournies dans les deux secteurs. En outre, les baisses de tarifs observées dans le secteur 2 ne contribuent pas à un rééquilibrage des comptes sociaux, puisqu'elles ne concernent que les dépassements. Enfin, nos évaluations permettent d'établir que les élasticités estimées au niveau microéconomique correspondent, au niveau macroéconomique, à une forte dérive de la consommation de soins en liaison avec l'augmentation du nombre de médecins. [eng] Health Care Demand Induced by French Self-Employed Doctors. A Microeconometric Study Based on Panel Data by Eric Delattre et Brigitte Dormont . A much-debated hypothesis in health economics is the supply-induced demand hypothesis (SID), which posits that suppliers can manipulate demand for their services. This article tests for the existence of SID behaviour u
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Suggested Citation

  • E Delattre & B. Dormont, 1999. "Induction de la demande de soins par les médecins libéraux français. Etude microéconométrique sur données de panel," THEMA Working Papers 99-21, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
    • Handle: RePEc:ema:worpap:99-21
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    2. Elise Coudin & Anne Pla & Anne‐Laure Samson, 2015. "GP responses to price regulation: evidence from a French nationwide reform," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1118-1130, September.
    3. Choné, P. & Coudin, É. & Pla, A., 2014. "Are physician fees responsive to competition?," Health, Econometrics and Data Group (HEDG) Working Papers 14/20, HEDG, c/o Department of Economics, University of York.
    4. Sophie Béjean & Christine Peyron & Renaud Urbinelli, 2007. "Variations in activity and practice patterns: a French study for GPs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 225-236, September.
    5. E. Delattre & B. Dormont, 2000. "Testing for supplier-induced demand behavior : A panel data study on French physicians," THEMA Working Papers 2000-42, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.

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