IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v126y2022i8p786-794.html
   My bibliography  Save this article

Does integrated care mean fewer hospitalizations? An evaluation of a French field experiment

Author

Listed:
  • Gaillard, Aurélie
  • García-Lorenzo, Borja
  • Renaud, Thomas
  • Wittwer, Jérôme

Abstract

This study aims to evaluate the impact of an experimental healthcare policy on hospital use among elderly patients. From 2015 to 2017, French public authorities implemented an integrated care model, the Digital Health Territories (Territoire de Soins Numérique (TSN)) programme designed to improve healthcare coordination and sustain the use of health information (HI) technologies. The TSN programme was expected to reduce hospital healthcare utilization. In the Aquitaine region, the TSN programme was implemented in part of the Landes district and primarily consisted of the creation of a support platform (PTA). Part of the Lot-et-Garonne district was chosen as a “control area” due to its similarities to the experimental district in terms of the population structure and healthcare supply characteristics. In the control area, no integrated care model innovation was implemented over the study period. Using claims data from the French National Health Insurance (Système National d'Information Inter-Régimes de l'Assurance Maladie (SNIIRAM)), the healthcare utilization of the populations living in the experimental and control areas was tracked from 2012 to 2017. To estimate the impact of the TSN programme on three hospitalization outcomes, we used a combination of matching and difference-in-differences (DiD) approaches. The TSN programme shows a significant but weak negative impact on emergency department (ED) visits and no significant impact on 30-day re-hospitalizations (R30) or potentially avoidable hospitalizations (PAHs).

Suggested Citation

  • Gaillard, Aurélie & García-Lorenzo, Borja & Renaud, Thomas & Wittwer, Jérôme, 2022. "Does integrated care mean fewer hospitalizations? An evaluation of a French field experiment," Health Policy, Elsevier, vol. 126(8), pages 786-794.
    • Handle: RePEc:eee:hepoli:v:126:y:2022:i:8:p:786-794
    DOI: 10.1016/j.healthpol.2022.05.009
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851022001221
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2022.05.009?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Or, Zeynep & Penneau, Anne, 2018. "A Multilevel Analysis of the determinants of emergency care visits by the elderly in France," Health Policy, Elsevier, vol. 122(8), pages 908-914.
    2. 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.
    3. Hainmueller, Jens, 2012. "Entropy Balancing for Causal Effects: A Multivariate Reweighting Method to Produce Balanced Samples in Observational Studies," Political Analysis, Cambridge University Press, vol. 20(1), pages 25-46, January.
    4. Lippi Bruni, Matteo & Mammi, Irene & Ugolini, Cristina, 2016. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Journal of Health Economics, Elsevier, vol. 50(C), pages 144-155.
    5. Hainmueller, Jens & Xu, Yiqing, 2013. "ebalance: A Stata Package for Entropy Balancing," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 54(i07).
    6. Daniel M. Walker, 2018. "Does participation in health information exchange improve hospital efficiency?," Health Care Management Science, Springer, vol. 21(3), pages 426-438, September.
    7. Alberto Abadie, 2005. "Semiparametric Difference-in-Differences Estimators," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 1-19.
    8. Morciano, Marcello & Checkland, Katherine & Billings, Jenny & Coleman, Anna & Stokes, Jonathan & Tallack, Charles & Sutton, Matt, 2020. "New integrated care models in England associated with small reduction in hospital admissions in longer-term: A difference-in-differences analysis," Health Policy, Elsevier, vol. 124(8), pages 826-833.
    Full references (including those not matched with items on IDEAS)

    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. Berger, Marius & Gottschalk, Sandra, 2021. "Financing and advising early stage startups: The effect of angel investor subsidies," ZEW Discussion Papers 21-069, ZEW - Leibniz Centre for European Economic Research.
    2. Michael Weber, 2016. "The short-run and long-run effects of decentralizing public employment services," ifo Working Paper Series 209, ifo Institute - Leibniz Institute for Economic Research at the University of Munich.
    3. Schumann, Mathias & Freier, Ronny & Siedler, Thomas, 2014. "The Economic Returns to Graduating with Honors - Evidence from Law Graduates," VfS Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100338, Verein für Socialpolitik / German Economic Association.
    4. Freier, Ronny & Schumann, Mathias & Siedler, Thomas, 2015. "The earnings returns to graduating with honors — Evidence from law graduates," Labour Economics, Elsevier, vol. 34(C), pages 39-50.
    5. Gabriel M Ahlfeldt, 2018. "Weights to Address Non-parallel Trends in Panel Difference-in-differences Models," CESifo Economic Studies, CESifo Group, vol. 64(2), pages 216-240.
    6. Søren Albeck Nielsen, 2021. "How to Cope with Dyslexia: The Effects of Special Education on Academic Performance, Personality Traits, and Well-being," Economics Working Papers 2021-13, Department of Economics and Business Economics, Aarhus University.
    7. Nielsen, Søren Albeck, 2023. "Boys left behind: The effects of summer camp and follow-up strategies on academic, personal, and social competencies," Economics of Education Review, Elsevier, vol. 93(C).
    8. Themann, Michael & Koch, Nicolas, 2021. "Catching up and falling behind: Cross-country evidence on the impact of the EU ETS on firm productivity," Ruhr Economic Papers 904, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    9. Everding, Jakob & Marcus, Jan, 2020. "The effect of unemployment on the smoking behavior of couples," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 29(2), pages 154-170.
    10. Jens Ruhose & Stephan L. Thomsen & Insa Weilage, 2018. "The Wider Benefits of Adult Learning: Work-Related Training and Social Capital," CESifo Working Paper Series 7268, CESifo.
    11. Agarwal, Vikas & Vashishtha, Rahul & Venkatachalam, Mohan, 2017. "Mutual fund transparency and corporate myopia," CFR Working Papers 16-10, University of Cologne, Centre for Financial Research (CFR), revised 2017.
    12. Jens Ruhose & Stephan L. Thomsen & Insa Weilage, 2018. "The Wider Benefits of Adult Learning: Work-Related Training and Social Capital," SOEPpapers on Multidisciplinary Panel Data Research 1004, DIW Berlin, The German Socio-Economic Panel (SOEP).
    13. Nikolova, Milena, 2018. "Self-Employment Can Be Good for Your Health," GLO Discussion Paper Series 226, Global Labor Organization (GLO).
    14. Robin Chen & Chia‐Wei Huang & Chih‐Yung Lin, 2022. "Board corruption and loan contracts," Journal of Business Finance & Accounting, Wiley Blackwell, vol. 49(9-10), pages 1929-1956, October.
    15. Ludovica Gambaro & Jan Marcus & Frauke Peter, 2019. "School entry, afternoon care, and mothers’ labour supply," Empirical Economics, Springer, vol. 57(3), pages 769-803, September.
    16. Fukui Hideki, 2023. "Evaluating Different Covariate Balancing Methods: A Monte Carlo Simulation," Statistics, Politics and Policy, De Gruyter, vol. 14(2), pages 205-326, June.
    17. Verena Lauber & Johanna Storck, 2016. "Helping with the Kids? How Family-Friendly Workplaces Affect Parental Well-Being and Behavior," SOEPpapers on Multidisciplinary Panel Data Research 883, DIW Berlin, The German Socio-Economic Panel (SOEP).
    18. Jacopo, Bonan & Stefano, Pareglio & Valentina, Rotondi, 2015. "Extension Services, Production and Welfare: Evidence from a Field Experiment in Ethiopia," Working Papers 312, University of Milano-Bicocca, Department of Economics, revised 30 Oct 2015.
    19. Nikolova, Milena, 2019. "Switching to self-employment can be good for your health," Journal of Business Venturing, Elsevier, vol. 34(4), pages 664-691.
    20. Müller, Tobias & Schmid, Christian & Gerfin, Michael, 2023. "Rents for Pills: Financial incentives and physician behavior," Journal of Health Economics, Elsevier, vol. 87(C).

    More about this item

    Keywords

    Field experiment; Integrated care; Emergency department visits; Elderly; Health policy evaluation;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C52 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Evaluation, Validation, and Selection

    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:eee:hepoli:v:126:y:2022:i:8:p:786-794. 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: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    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.