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Maisons et pôles de santé : places et impacts dans les dynamiques territoriales d’offre de soins en France

Author

Listed:
  • Guillaume Chevillard

    (UPOND Université Paris Ouest Nanterre La Défense, Laboratoire Mosaïques, UMR Lavue 7218 CNRS)

  • Julien Mousquès

    (IRDES Institut de recherche et documentation en économie de la santé)

  • Véronique Lucas-Gabrielli

    (IRDES Institut de recherche et documentation en économie de la santé)

  • Yann Bourgueil

    (IRDES Institut de recherche et documentation en économie de la santé)

  • Stéphane Rican

    (UPOND Université Paris Ouest Nanterre La Défense, Laboratoire Mosaïques, UMR Lavue 7218 CNRS)

  • Gérard Salem

    (UPOND Université Paris Ouest Nanterre La Défense, Laboratoire Mosaïques, UMR Lavue 7218 CNRS)

Abstract

Depuis une dizaine d’années, les pouvoirs publics encouragent le regroupement pluriprofessionnel en soins de premiers recours, notamment en direction des maisons et pôles de santé. Ces structures ont pour vocation première de maintenir ou renforcer l’offre de soins dans les espaces fragiles. Cette étude décrit les espaces dans lesquels sont implantés les maisons et pôles de santé, et analyse l’évolution de la densité de médecins généralistes dans ces espaces. Deux typologies ont été réalisées, qui distinguent les espaces à dominante urbaine et à dominante rurale, permettant une analyse spécifique de ceux-ci. Ces typologies décrivent les espaces d’implantation des maisons et pôles de santé selon les caractéristiques de la population, de l’offre de soins et de la structure spatiale de ceux-ci. Ces typologies permettent, dans un second temps, d’analyser l’évolution de la densité de médecins généralistes dans ces espaces, selon qu’ils abritent ou non des maisons et pôles de santé. Les premiers résultats montrent que ces structures sont majoritairement implantées dans des espaces à dominante rurale plus fragiles en termes d’offre de soins, ce qui suggère une logique d’implantation des maisons et pôles de santé qui répond à l’objectif de maintenir une offre là où les besoins sont importants. On observe une moindre diminution de la densité des médecins généralistes entre 2008 et 2011 dans ces espaces, comparés à ceux du même type mais sans maisons et pôles de santé. Dans les espaces à dominante urbaine, dans lesquels ces structures sont moins présentes, la logique d’implantation suggère également une logique de rééquilibrage de l’offre de soins de premiers recours en faveur des espaces périurbains moins dotés. En outre, on constate une évolution plus favorable de la densité de médecins généralistes.

Suggested Citation

  • 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.
  • Handle: RePEc:irh:wpaper:dt57
    as

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    References listed on IDEAS

    as
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    Full references (including those not matched with items on IDEAS)

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    Cited by:

    1. Pierre, Aurélie & Jusot, Florence, 2017. "The likely effects of employer-mandated complementary health insurance on health coverage in France," Health Policy, Elsevier, vol. 121(3), pages 321-328.

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    More about this item

    Keywords

    Démographie médicale; expérimentation des nouveaux modes de rémunération; évaluation de politiques publiques; géographie de la santé; maisons et pôles de santé; offre de soins de premiers recours; organisation des soins;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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