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General Practitioners activity patterns: the medium-term impacts of Primary Care Teams in France

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  • Cassou, Matthieu
  • Mousquès, Julien
  • Franc, Carine

Abstract

Faced with the fragmentation of the French primary care system, public policies aim to promote multiprofessional teamwork to improve both delivery efficiency and health professionals’ working conditions. Thus, a practice-level add-on payment backed by cooperation commitments is implemented to foster and sustain the development of multiprofessional primary care groups (MPCGs). We study the impact of practising in MPCGs for general practitioners (GPs) in terms of the supply of care, practice patterns and income. Based on this quasiexperimental framework with a panel dataset covering the period 2005-2017, we account for the selection into MPCGs by combining a difference-in-differences design with propensity score matching to prebalance samples. We show that GPs in MPCGs increased their patient list more rapidly than control GPs (+10% increase of encountered patients) without increasing their provision of services (number of visits and drug prescriptions) more rapidly. Instead, compared to control GPs, MPCG GPs had a significantly faster reduction in the average number of visits (+5.5% reduction) and the euro-amounts of drug prescriptions per patient (+7.2% reduction) and other prescriptions. The growth of these effects between the short and medium term moreover suggests that the properties of multi-professional coordination and cooperation need time to develop.

Suggested Citation

  • Cassou, Matthieu & Mousquès, Julien & Franc, Carine, 2023. "General Practitioners activity patterns: the medium-term impacts of Primary Care Teams in France," Health Policy, Elsevier, vol. 136(C).
    • Handle: RePEc:eee:hepoli:v:136:y:2023:i:c:s0168851023001537
    DOI: 10.1016/j.healthpol.2023.104868
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    1. Encinosa III, William E. & Gaynor, Martin & Rebitzer, James B., 2007. "The sociology of groups and the economics of incentives: Theory and evidence on compensation systems," Journal of Economic Behavior & Organization, Elsevier, vol. 62(2), pages 187-214, February.
    2. Dumontet, Magali & Buchmueller, Thomas & Dourgnon, Paul & Jusot, Florence & Wittwer, Jérôme, 2017. "Gatekeeping and the utilization of physician services in France: Evidence on the Médecin traitant reform," Health Policy, Elsevier, vol. 121(6), pages 675-682.
    3. 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.
    4. Peter R. Mueser & Kenneth R. Troske & Alexey Gorislavsky, 2007. "Using State Administrative Data to Measure Program Performance," The Review of Economics and Statistics, MIT Press, vol. 89(4), pages 761-783, November.
    5. Tomoko Ono & Michael Schoenstein & James Buchan, 2014. "Geographic Imbalances in Doctor Supply and Policy Responses," OECD Health Working Papers 69, OECD Publishing.
    6. Julien Silhol & Bruno Ventelou & Anna Zaytseva, 2020. "How French general practitioners respond to declining medical density: a study on prescription practices, with an insight into opioids use," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1391-1398, December.
    7. A. Colin Cameron & Douglas L. Miller, 2015. "A Practitioner’s Guide to Cluster-Robust Inference," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 317-372.
    8. Sisira Sarma & Rose Anne Devlin & William Hogg, 2010. "Physician's production of primary care in Ontario, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 14-30, January.
    9. Groenewegen, Peter & Heinemann, Stephanie & Greß, Stefan & Schäfer, Willemijn, 2015. "Primary care practice composition in 34 countries," Health Policy, Elsevier, vol. 119(12), pages 1576-1583.
    10. Alberto Abadie, 2005. "Semiparametric Difference-in-Differences Estimators," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 1-19.
    11. Olga Milliken & Rose Anne Devlin & Victoria Barham & William Hogg & Simone Dahrouge, 2011. "Comparative Efficiency Assessment of Primary Care Service Delivery Models Using Data Envelopment Analysis," Canadian Public Policy, University of Toronto Press, vol. 37(1), pages 85-109, March.
    12. Mikol, Fanny & Franc, Carine, 2019. "Gender differences in the incomes of self-employed French physicians: The role of family structure," Health Policy, Elsevier, vol. 123(7), pages 666-674.
    13. King, Gary & Nielsen, Richard, 2019. "Why Propensity Scores Should Not Be Used for Matching," Political Analysis, Cambridge University Press, vol. 27(4), pages 435-454, October.
    14. Jesmin, Shammima & Thind, Amardeep & Sarma, Sisira, 2012. "Does team-based primary health care improve patients’ perception of outcomes? Evidence from the 2007–08 Canadian Survey of Experiences with Primary Health," Health Policy, Elsevier, vol. 105(1), pages 71-83.
    15. Reinhardt, U, 1972. "A Product Function for Physician Services," The Review of Economics and Statistics, MIT Press, vol. 54(1), pages 55-66, February.
    16. Chevillard, Guillaume & Mousquès, Julien, 2021. "Medically underserved areas: are primary care teams efficient at attracting and retaining general practitioners?," Social Science & Medicine, Elsevier, vol. 287(C).
    17. Ho, Daniel E. & Imai, Kosuke & King, Gary & Stuart, Elizabeth A., 2007. "Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference," Political Analysis, Cambridge University Press, vol. 15(3), pages 199-236, July.
    18. Strumpf, Erin & Ammi, Mehdi & Diop, Mamadou & Fiset-Laniel, Julie & Tousignant, Pierre, 2017. "The impact of team-based primary care on health care services utilization and costs: Quebec’s family medicine groups," Journal of Health Economics, Elsevier, vol. 55(C), pages 76-94.
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    More about this item

    Keywords

    Primary Care; General Practitioner; Care and services; Teamwork; Difference-in-differences; Panel Data;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models

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