Effets des réseaux de télémédecine sur la durée de séjour et l’intensité des transferts des patients : application au réseau Périn@t à l’aide d’un modèle de durée à population séparée à effet aléatoire

This study highlights the effects of telemedicine networks on the length of stays and the frequency of patient transfers. We retain the natural experience of the Périn@t network in obstetrics and apply three econometric models to data from six Breton maternity wards in 2004: Logit and Cox models, in addition to our split-population duration model with random effect. The results show that cooperation in this network makes it possible to reduce the frequency of transfers and to decide on transfers quickly from the first days of admission. We also note that maternity wards practice severity overdiagnosis strategies in order to increase transfers. Inflation of transfers is an adverse effect of fee-for-service. No hospital funding system allows for efficient management or optimal practice of transfers. Our empirical results show that telemedicine networks are a relevant mechanism. JEL classification: C34, C51, I11, I18.