The preferred doctor scheme: A political reading of a French experiment of Gate-keeping
AbstractObjectives Since 2006 France experiences an innovative version of Gate-keeping which aims at regulating access to outpatient specialist care. We describe the reform's initial objectives, the political pathway which lead to the implementation of a reshaped reform and discuss the first outcomes after 1 year implementation. In the conclusion, we try to catch a glimpse for future steps of the reform.Methods In order to observe the implantation and impact on the reform, we used national sickness fund databases and a sample of 7198 individuals from the 2006 French Health, Health Care and Insurance Survey (ESPS), including health, socio-economic and insurance status, questions relating to patient's understanding and compliance with the scheme, self-assessed unmet specialist needs since the reform.Results and discussion 2006 results show that 94% chose a preferred doctor, in a vast majority their family doctor. Impact on access to specialist care appears significant for the less well off and those not covered by a complementary insurance. From the specialist's side, new constraints on access to care seem to have been offset by rises in fee schedules.Conclusion Notwithstanding disappointing short terms results, the new scheme may however lead up to reinforced managed care reforms.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoArticle provided by Elsevier in its journal Health Policy.
Volume (Year): 94 (2010)
Issue (Month): 2 (February)
Contact details of provider:
Web page: http://www.elsevier.com/locate/healthpol
Health care reform Gate-keeping Evaluation studies;
Other versions of this item:
- Michel Naiditch & Paul Dourgnon, 2009. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Working Papers DT22, IRDES institut for research and information in health economics, revised Mar 2009.
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.
- Dourgnon, Paul, 2013. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/12221 edited by Wittwer, Jérôme, December.
- Mousquès, Julien & Bourgueil, Yann & Le Fur, Philippe & Yilmaz, Engin, 2010.
"Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care,"
Elsevier, vol. 98(2-3), pages 131-143, December.
- Julien Mousquès & Yann Bourgueil & Philippe Le Fur & Engin Yilmaz, 2010. "Effect of a French Experiment of Team Work between General Practitioners and Nurses on Efficacy and Cost of Type 2 Diabetes Patients Care," Working Papers DT29, IRDES institut for research and information in health economics, revised Jan 2010.
- Thierry Debrand & Nicolas Sirven, 2009. "What are the Motivations of Pathways to Retirement in Europe: Individual, Familial, Professional Situation or Social Protection Systems?," Working Papers DT28, IRDES institut for research and information in health economics, revised Oct 2009.
- Thierry Debrand & Christine Sorasith, 2010. "Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity," Working Papers DT34, IRDES institut for research and information in health economics, revised Nov 2010.
- Guillaume Chevillard & Julien Mousquès & Véronique Lucas-Gabrielli & Yann Bourgueil & Stéphane Rican & Gérard Salem, 2013. "Maisons et pôles de santé : places et impacts dans les dynamiques territoriales d'offre de soins en France," Working Papers DT57, IRDES institut for research and information in health economics, revised Nov 2013.
- Or, Zeynep & Cases, Chantal & Lisac, Melanie & Vrangbæk, Karsten & Winblad, Ulrika & Bevan, Gwyn, 2010.
"Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems,"
Health Economics, Policy and Law,
Cambridge University Press, vol. 5(03), pages 269-293, July.
- Zeynep Or & Chantal Cases & Melanie Lisac & Karsten Vrangbaek & Ulrika Winblad & Gwyn Bevan, 2009. "Are Health Problems Systemic? Politics of Access and Choice under Beveridge and Bismarck Systems," Working Papers DT27, IRDES institut for research and information in health economics, revised Sep 2009.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei) or () The email address of this maintainer does not seem to be valid anymore. Please ask to update the entry or send us the correct address.
If references are entirely missing, you can add them using this form.