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L'hypothèse de demande induite : un bilan économique

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  • Stéphane Jacobzone
  • Lise Rochaix

Abstract

[eng] The Induced Demand Hypothesis: an Economic Assessment by Lise Rochaix and Stéphane Jacobzone . In health economics the induced demand hypothesis is bringing about a transformation in the way health-care demand is perceived. It posits that health-care demand does not simply reflect choice in terms of patient utility but can also be determined by a doctor's implicit motivation. This extremely polemical hypothesis has formed the basis for numerous empirical studies. In this paper we demonstrate that the controversy arises partly from the exact formulation of the hypothesis. A detailed analysis of available work on the extent of induced demand leads to a qualified judgement. On the empirical level, the academic debate seems to be partly closed, although it has not been definitively resolved given the limitations of the tools. Nevertheless, this economic assessment underlines the weight of the incentives to which doctors are exposed in the practice of their profession. This is not without an effect on discussion of payment systems for providers and may shed light on certain economic policy choices. [fre] L'hypothèse de demande induite : un bilan économique par Lise Rochaix et Stéphane Jacobzone . En économie de la santé, l'hypothèse de demande induite conduit à transformer la perception de la demande de soins. Celle-ci ne refléterait pas seulement les choix en termes d'utilité du patient, mais pourrait aussi être déterminée par les motivations implicites du médecin. Cette hypothèse très discutée a fait l'objet de multiples études empiriques. Nous montrons ici que les controverses dépendent pour partie de la formulation exacte de l'hypothèse. Une analyse fouillée des travaux disponibles quant à l'ampleur de la demande induite conduit à une appréciation nuancée. Au niveau empirique, le débat académique semble en partie clos et n'est pas définitivement tranché, compte tenu des limites des outils. Néanmoins, un tel bilan souligne l'importance des incitations auxquelles sont exposés les médecins dans leur pratique. Ceci n'est pas sans incidence quant à la réflexion en termes de mécanismes de rémunération des offreurs et peut éclairer certains choix de politique économique.

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Bibliographic Info

Article provided by Programme National Persée in its journal Économie & prévision.

Volume (Year): 129 (1997)
Issue (Month): 3 ()
Pages: 25-36

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Handle: RePEc:prs:ecoprv:ecop_0249-4744_1997_num_129_3_5862

Note: DOI:10.3406/ecop.1997.5862
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References

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  1. Mark Pauly, 1980. "Doctors and Their Workshops: Economic Models of Physician Behavior," NBER Books, National Bureau of Economic Research, Inc, number paul80-1.
  2. Birch, Stephen, 1988. "The identification of supplier-inducement in a fixed price system of health care provision : The case of dentistry in the United Kingdom," Journal of Health Economics, Elsevier, vol. 7(2), pages 129-150, June.
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  4. Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, vol. 26(2), pages 281-98, April.
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  8. Janssen, Richard, 1992. "Time prices and the demand for GP services," Social Science & Medicine, Elsevier, vol. 34(7), pages 725-733, April.
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  10. Labelle, Roberta & Stoddart, Greg & Rice, Thomas, 1994. "A re-examination of the meaning and importance of supplier-induced demand," Journal of Health Economics, Elsevier, vol. 13(3), pages 347-368, October.
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  14. Stano, Miron, 1987. "A further analysis of the physician inducement controversy," Journal of Health Economics, Elsevier, vol. 6(3), pages 227-238, September.
  15. Mitchell, Jean M. & Sass, Tim R., 1995. "Physician ownership of ancillary services: Indirect demand inducement or quality assurance?," Journal of Health Economics, Elsevier, vol. 14(3), pages 263-289, August.
  16. Martin Gaynor, 1989. "Competition within the Firm: Theory Plus Some Evidence from Medical Group Practice," RAND Journal of Economics, The RAND Corporation, vol. 20(1), pages 59-76, Spring.
  17. Joseph P. Newhouse & Charles E. Phelps, 1976. "New Estimates of Price and Income Elasticities of Medical Care Services," NBER Chapters, in: The Role of Health Insurance in the Health Services Sector, pages 261-320 National Bureau of Economic Research, Inc.
  18. McCarthy, Thomas R., 1985. "The competitive nature of the primary-care physician services market," Journal of Health Economics, Elsevier, vol. 4(2), pages 93-117, June.
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  21. Hoerger, Thomas J., 1990. "Two-part pricing and the mark-ups charged by primary care physicians for new and established patient visits," Journal of Health Economics, Elsevier, vol. 8(4), pages 399-417, February.
  22. Hay, Joel & Leahy, Michael J., 1982. "Physician-induced demand : An empirical analysis of the consumer information gap," Journal of Health Economics, Elsevier, vol. 1(3), pages 231-244, December.
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  24. Richard D. Auster & Ronald L. Oaxaca, 1981. "Identification of Supplier Induced Demand in the Health Care Sector," Journal of Human Resources, University of Wisconsin Press, vol. 16(3), pages 327-342.
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Cited by:
  1. 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.
  2. R. Mahieu, 2000. "The determinants of health care expenditure: a macroeconomic approach," Documents de Travail de la DESE - Working Papers of the DESE g2000-01, Institut National de la Statistique et des Etudes Economiques, DESE.
  3. 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.
  4. Lise Rochaix, 1997. "Asymétries d'information et incertitude en santé : les apports de la théorie des contrats," Économie et Prévision, Programme National Persée, vol. 129(3), pages 11-24.
  5. Philippe Batifoulier & Nicolas Da Silva, 2014. "The economic behaviour of doctors: medical altruism without an ethic?," EconomiX Working Papers 2014-9, University of Paris West - Nanterre la Défense, EconomiX.
  6. Jeanne Lievaut & Philippe Batifoulier, 2011. "La transformation des actes gratuits en actes payants en médecine libérale. Une étude micro-économétrique longitudinale," EconomiX Working Papers 2011-12, University of Paris West - Nanterre la Défense, EconomiX.
  7. Lise Rochaix, 2004. "Les modes de rémunération des médecins," Revue d'Économie Financière, Programme National Persée, vol. 76(3), pages 223-239.
  8. Philippe Batifoulier, 2014. "De l’aléa moral du patient aux inégalités d’accès aux soins," EconomiX Working Papers 2014-7, University of Paris West - Nanterre la Défense, EconomiX.
  9. Bruno Ventelou & Vincent Touze, 2001. "Politique de santé dans un modèle macroéconomique," Sciences Po publications info:hdl:2441/4303, Sciences Po.
  10. repec:spo:wpecon:info:hdl:2441/4303 is not listed on IDEAS

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