IDEAS home Printed from https://ideas.repec.org/p/hal/journl/hal-03171227.html
   My bibliography  Save this paper

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

Author

Listed:
  • Christophe Loussouarn

    (ERUDITE - Equipe de Recherche sur l’Utilisation des Données Individuelles en lien avec la Théorie Economique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12 - Université Gustave Eiffel, IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

  • Carine Franc

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

  • Yann Videau

    (ERUDITE - Equipe de Recherche sur l’Utilisation des Données Individuelles en lien avec la Théorie Economique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12 - Université Gustave Eiffel)

  • Julien Mousquès

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

Abstract

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-in-differences estimates on panel data. We find a small positive impact on the number of GP working days (+1.2%) following enrollment and a more pronounced effect on the number of patients seen (+7.55%) or registered (+6.87%). 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.

Suggested Citation

  • Christophe Loussouarn & Carine Franc & Yann Videau & Julien Mousquès, 2021. "Can General Practitioners Be More Productive? The Impact of Teamwork and Cooperation with Nurses on GP Activities," Post-Print hal-03171227, HAL.
    • Handle: RePEc:hal:journl:hal-03171227
    DOI: 10.1002/hec.4214
    as

    Download full text from publisher

    To our knowledge, this item is not available for download. To find whether it is available, there are three options:
    1. Check below whether another version of this item is available online.
    2. Check on the provider's web page whether it is in fact available.
    3. Perform a search for a similarly titled item that would be available.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Alchian, Armen A & Demsetz, Harold, 1972. "Production , Information Costs, and Economic Organization," American Economic Review, American Economic Association, vol. 62(5), pages 777-795, December.
    2. Dumontet, Magali & Buchmueller, Thomas & Dourgnon, Paul & Jusot, Florence & Wittwer, Jérôme, 2017. "Gatekeeping and the utilization of physician services in France: Evidence on the Médecin traitant reform," Health Policy, Elsevier, vol. 121(6), pages 675-682.
    3. James J. Heckman & Hidehiko Ichimura & Petra E. Todd, 1997. "Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 64(4), pages 605-654.
    4. Aghion, Philippe & Tirole, Jean, 1997. "Formal and Real Authority in Organizations," Journal of Political Economy, University of Chicago Press, vol. 105(1), pages 1-29, February.
    5. Canice Prendergast, 1999. "The Provision of Incentives in Firms," Journal of Economic Literature, American Economic Association, vol. 37(1), pages 7-63, March.
    6. Edward P. Lazear & Kathryn L. Shaw, 2007. "Personnel Economics: The Economist's View of Human Resources," Journal of Economic Perspectives, American Economic Association, vol. 21(4), pages 91-114, Fall.
    7. ,, 2002. "Problems And Solutions," Econometric Theory, Cambridge University Press, vol. 18(1), pages 193-194, February.
    8. repec:ner:ucllon:http://discovery.ucl.ac.uk/17678/ is not listed on IDEAS
    9. ,, 2002. "Problems And Solutions," Econometric Theory, Cambridge University Press, vol. 18(2), pages 541-545, April.
    10. Tsiachristas, A. & Wallenburg, I. & Bond, C.M. & Elliot, R.F. & Busse, R. & van Exel, J. & Rutten-van Mölken, M.P. & de Bont, A., 2015. "Costs and effects of new professional roles: Evidence from a literature review," Health Policy, Elsevier, vol. 119(9), pages 1176-1187.
    11. Groenewegen, Peter & Heinemann, Stephanie & Greß, Stefan & Schäfer, Willemijn, 2015. "Primary care practice composition in 34 countries," Health Policy, Elsevier, vol. 119(12), pages 1576-1583.
    12. Barton H. Hamilton & Jack A. Nickerson & Hideo Owan, 2003. "Team Incentives and Worker Heterogeneity: An Empirical Analysis of the Impact of Teams on Productivity and Participation," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 465-497, June.
    13. Alberto Abadie, 2005. "Semiparametric Difference-in-Differences Estimators," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 1-19.
    14. ,, 2002. "Problems And Solutions," Econometric Theory, Cambridge University Press, vol. 18(4), pages 1007-1017, August.
    15. King, Gary & Nielsen, Richard, 2019. "Why Propensity Scores Should Not Be Used for Matching," Political Analysis, Cambridge University Press, vol. 27(4), pages 435-454, October.
    16. Kim Olsen & Dorte Gyrd-Hansen & Torben Sørensen & Troels Kristensen & Peter Vedsted & Andrew Street, 2013. "Organisational determinants of production and efficiency in general practice: a population-based study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 267-276, April.
    17. ,, 2002. "Problems And Solutions," Econometric Theory, Cambridge University Press, vol. 18(6), pages 1461-1465, December.
    18. ,, 2002. "Problems And Solutions," Econometric Theory, Cambridge University Press, vol. 18(5), pages 1273-1289, October.
    19. Julien Silhol & Bruno Ventelou & Anna Zaytseva & Claire Marbot, 2019. "Comportements et pratiques des médecins : exercer dans les zones les moins dotées, cela fait-il une différence ?," Post-Print hal-02475133, HAL.
    20. Iacus, Stefano M. & King, Gary & Porro, Giuseppe, 2012. "Causal Inference without Balance Checking: Coarsened Exact Matching," Political Analysis, Cambridge University Press, vol. 20(1), pages 1-24, January.
    21. ,, 2002. "Problems And Solutions," Econometric Theory, Cambridge University Press, vol. 18(3), pages 819-821, June.
    22. Strumpf, Erin & Ammi, Mehdi & Diop, Mamadou & Fiset-Laniel, Julie & Tousignant, Pierre, 2017. "The impact of team-based primary care on health care services utilization and costs: Quebec’s family medicine groups," Journal of Health Economics, Elsevier, vol. 55(C), pages 76-94.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 8th March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-08 12:00:01

    Citations

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


    Cited by:

    1. Anna Zaytseva & Pierre Verger & Bruno Ventelou, 2021. "United, we can be stronger! French integrated general practitioners had better chronic care follow-up during lockdown," Working Papers halshs-03227216, HAL.
    2. Vanessa Ress & Eva‐Maria Wild, 2024. "The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework," Health Economics, John Wiley & Sons, Ltd., vol. 33(2), pages 229-247, February.

    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. Christophe Loussouarn & Carine Franc & Yann Videau & Julien Mousquès, 2019. "Coopérer plus pour travailler plus : évaluation de l’expérimentation d’infirmière de pratique avancée Asalée sur l’activité du médecin généraliste," Erudite Working Paper 2019-13, Erudite.
    2. Bruno Frey, 2005. "Problems with Publishing: Existing State and Solutions," European Journal of Law and Economics, Springer, vol. 19(2), pages 173-190, April.
    3. Claudia García-García & Catalina B. García-García & Román Salmerón, 2021. "Confronting collinearity in environmental regression models: evidence from world data," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 30(3), pages 895-926, September.
    4. Cambier, Adrien & Chardy, Matthieu & Figueiredo, Rosa & Ouorou, Adam & Poss, Michael, 2022. "Optimizing subscriber migrations for a telecommunication operator in uncertain context," European Journal of Operational Research, Elsevier, vol. 298(1), pages 308-321.
    5. Libura, Marek, 2007. "On the adjustment problem for linear programs," European Journal of Operational Research, Elsevier, vol. 183(1), pages 125-134, November.
    6. Tschakert, Petra, 2016. "Shifting Discourses of Vilification and the Taming of Unruly Mining Landscapes in Ghana," World Development, Elsevier, vol. 86(C), pages 123-132.
    7. María-Consuelo Casabán & Rafael Company & Lucas Jódar, 2020. "Non-Gaussian Quadrature Integral Transform Solution of Parabolic Models with a Finite Degree of Randomness," Mathematics, MDPI, vol. 8(7), pages 1-16, July.
    8. Isabelle Boutron & Peter John & David J. Torgerson, 2010. "Reporting Methodological Items in Randomized Experiments in Political Science," The ANNALS of the American Academy of Political and Social Science, , vol. 628(1), pages 112-131, March.
    9. Ben Slimane, Faten & Padilla Angulo, Laura, 2019. "Strategic change and corporate governance: Evidence from the stock exchange industry," Journal of Business Research, Elsevier, vol. 103(C), pages 206-218.
    10. Bossert, Walter & Derks, Jean & Peters, Hans, 2005. "Efficiency in uncertain cooperative games," Mathematical Social Sciences, Elsevier, vol. 50(1), pages 12-23, July.
    11. Weijun Xie & Yanfeng Ouyang & Sze Chun Wong, 2016. "Reliable Location-Routing Design Under Probabilistic Facility Disruptions," Transportation Science, INFORMS, vol. 50(3), pages 1128-1138, August.
    12. Sin-Yu Ho & N.M. Odhiambo, 2018. "Analysing the macroeconomic drivers of stock market development in the Philippines," Cogent Economics & Finance, Taylor & Francis Journals, vol. 6(1), pages 1451265-145, January.
    13. Natalia Nikolaevna Natocheeva* & Yuri Alexandrovich Rovensky & Yuri Yuryevich Rusanov & Tatiana Viktorovna Belyanchikova & Anna Anatolevna Staurskaya, 2018. "Optimizing Variability of Approaches to Regulatory Financing of Higher Education Services," The Journal of Social Sciences Research, Academic Research Publishing Group, pages 221-227:3.
    14. Philip Arestis & Howard Stein, 2005. "An Institutional Perspective to Finance and Development as an Alternative to Financial Liberalisation," International Review of Applied Economics, Taylor & Francis Journals, vol. 19(4), pages 381-398.
    15. Sahar Validi & Arijit Bhattacharya & P. J. Byrne, 2020. "Sustainable distribution system design: a two-phase DoE-guided meta-heuristic solution approach for a three-echelon bi-objective AHP-integrated location-routing model," Annals of Operations Research, Springer, vol. 290(1), pages 191-222, July.
    16. Cabada, Alberto & Fernández-Gómez, Carlos, 2015. "Constant sign solutions of two-point fourth order problems," Applied Mathematics and Computation, Elsevier, vol. 263(C), pages 122-133.
    17. Andy Hall, 2005. "Capacity development for agricultural biotechnology in developing countries: an innovation systems view of what it is and how to develop it," Journal of International Development, John Wiley & Sons, Ltd., vol. 17(5), pages 611-630.
    18. Athinoula A. Kosti & Simon Colreavy-Donnelly & Fabio Caraffini & Zacharias A. Anastassi, 2020. "Efficient Computation of the Nonlinear Schrödinger Equation with Time-Dependent Coefficients," Mathematics, MDPI, vol. 8(3), pages 1-12, March.
    19. Lan, Heng-you, 2021. "Approximation-solvability of population biology systems based on p-Laplacian elliptic inequalities with demicontinuous strongly pseudo-contractive operators," Chaos, Solitons & Fractals, Elsevier, vol. 150(C).
    20. D. F. M. Torres & G. Leitmann, 2008. "Contrasting Two Transformation-based Methods for Obtaining Absolute Extrema," Journal of Optimization Theory and Applications, Springer, vol. 137(1), pages 53-59, April.

    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:hal:journl:hal-03171227. 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: CCSD (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    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.