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Centralization of care in high volume hospitals and inequalities in access to care

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  • Huguet, Marius

Abstract

In 2018, the French National Health Insurance proposed to increase the minimum volume threshold for breast cancer and to set a specific threshold for ovarian cancer in order to get an authorization to treat these patients. Using an exhaustive nationwide data set, the aim of this study is to evaluate the impact of the application of minimum volume thresholds for breast cancer and ovarian cancer in France on socioeconomic and spatial inequalities in patient access to care, taking into account patient preferences for their preferred provider. Our findings indicate that it would increase spatial inequalities and introduce socioeconomic inequalities in access to specialized care in terms of travel distance and will contribute to the medical desertification in rural areas that already have less access to non-specialized care. Our results underline that ignoring patient preferences when assessing the impact of such policies drastically underestimate the deterioration in patient access to care.

Suggested Citation

  • Huguet, Marius, 2020. "Centralization of care in high volume hospitals and inequalities in access to care," Social Science & Medicine, Elsevier, vol. 260(C).
    • Handle: RePEc:eee:socmed:v:260:y:2020:i:c:s0277953620303968
    DOI: 10.1016/j.socscimed.2020.113177
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    References listed on IDEAS

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    6. Marius Huguet & Lionel Perrier & Olivia Bally & David Benayoun & Pierre de Saint Hilaire & Dominique Beal Ardisson & Magali Morelle & Nathalie Havet & Xavier Joutard & Pierre Méeus & Philippe Gabelle , 2018. "Being Treated In Higher Volume Hospitals Leads To Longer Progression-Free Survival For Epithelial Ovarian Carcinoma Patients in the Rhone-Alpes region of France," Post-Print halshs-01670155, HAL.
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    Cited by:

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    More about this item

    Keywords

    Inequalities; Access to care; Volume outcome relationship; France; Epithelial ovarian cancer; Breast cancer; Organization of care; Minimum volume standard; Centralization of care; Volume-threshold;
    All these keywords.

    JEL classification:

    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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