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L'hypothèse de demande induite : un bilan économique

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  • Lise Rochaix
  • Stéphane Jacobzone

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.

Suggested Citation

  • Lise Rochaix & Stéphane Jacobzone, 1997. "L'hypothèse de demande induite : un bilan économique," Économie et Prévision, Programme National Persée, vol. 129(3), pages 25-36.
    • Handle: RePEc:prs:ecoprv:ecop_0249-4744_1997_num_129_3_5862
    DOI: 10.3406/ecop.1997.5862
    Note: DOI:10.3406/ecop.1997.5862
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    Cited by:

    1. repec:spo:wpecon:info:hdl:2441/4303 is not listed on IDEAS
    2. Nicolas Couderc & Bruno Ventelou & Vincent Touzé, 2001. "Politiques de santé dans un modèle macroéconomique," Post-Print hal-03428452, HAL.
    3. Sabine Chaupain-Guillot & Olivier Guillot, 2015. "Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 781-796, September.
    4. Lise Rochaix, 2004. "Les modes de rémunération des médecins," Revue d'Économie Financière, Programme National Persée, vol. 76(3), pages 223-239.
    5. repec:hal:wpspec:info:hdl:2441/4303 is not listed on IDEAS
    6. Jeanne Lievaut & Philippe Batifoulier, 2011. "La transformation des actes gratuits en actes payants en médecine libérale. Une étude micro-économétrique longitudinale," Working Papers hal-04141002, HAL.
    7. Philippe Batifoulier, 2014. "De l’aléa moral du patient aux inégalités d’accès aux soins," Working Papers hal-04141361, HAL.
    8. Éric Delattre & Brigitte Dormont, 2000. "Induction de la demande de soins par les médecins libéraux français. Étude micro-économétrique sur données de panel," Économie et Prévision, Programme National Persée, vol. 142(1), pages 137-161.
    9. Bruno Ventelou, 1999. "Les dépenses de santé des Français : une maladie d'amour?," Revue de l'OFCE, Programme National Persée, vol. 71(1), pages 247-280.
    10. 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.
    11. Aleksandr Proshin & Alexandre Cazenave-Lacroutz & Zeynep Or & Lise Rochaix, 2018. "Impact of Diagnosis Related Group Refinement on the Choice Between Scheduled Caesarean Section and Normal Delivery: Recent Evidence from France," Working Papers halshs-01812107, HAL.
    12. Philippe Batifoulier & Nicolas Da Silva, 2014. "The economic behaviour of doctors: medical altruism without an ethic?," EconomiX Working Papers 2014-9, University of Paris Nanterre, EconomiX.
    13. Philippe Batifoulier, 2014. "De l’aléa moral du patient aux inégalités d’accès aux soins," EconomiX Working Papers 2014-7, University of Paris Nanterre, EconomiX.
    14. 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.
    15. repec:hal:spmain:info:hdl:2441/4303 is not listed on IDEAS
    16. 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 Nanterre, EconomiX.
    17. Frédéric Rupprecht & Bruno Tissot & Frédéric Chatel, 1998. "Le système de santé allemand : vers une plus grande responsabilisation de l'ensemble des acteurs," Économie et Statistique, Programme National Persée, vol. 318(1), pages 17-40.

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