IDEAS home Printed from https://ideas.repec.org/a/nse/ecosta/ecostat_2021_524d_2.html
   My bibliography  Save this article

The Introduction of Pay-for-Performance: What Impact on General Practitioners' Activity in France?

Author

Listed:
  • Brigitte Dormont
  • Aimée Kingsada
  • Anne-Laure Samson

Abstract

[eng] In 2009, a system of pay-for-performance (P4P) was offered to physicians in France via the Contrat d’Amélioration des Pratiques Individuelles (CAPI). This study assesses the causal impact of CAPI on their behaviour in terms of care provision. Based on a panel of general practitioners in private practice observed before (2005 and 2008) and after (2011) its introduction, we use an instrumental variables approach, applied to a model in first-differences in order to correct the endogeneity biases linked to the fact that signing up to CAPI is a choice. We show that, unlike other practitioners, those who have signed up to CAPI have not reduced their number of consultations per patient or the amount of prescriptions per patient. They have also increased, to a greater extent than others, the proportion of their patients who they treat as the primary care doctor(i.e. the médecin traitant). Moreover, CAPI has enabled them to increase their fees per patient with, as a consequence, a higher treatment cost for the Social Security system.

Suggested Citation

  • Brigitte Dormont & Aimée Kingsada & Anne-Laure Samson, 2021. "The Introduction of Pay-for-Performance: What Impact on General Practitioners' Activity in France?," Economie et Statistique / Economics and Statistics, Institut National de la Statistique et des Etudes Economiques (INSEE), issue 524-525, pages 11-29.
    • Handle: RePEc:nse:ecosta:ecostat_2021_524d_2
    DOI: https://doi.org/10.24187/ecostat.2021.524d.2045
    as

    Download full text from publisher

    File URL: https://www.insee.fr/en/statistiques/fichier/5396130/02_ES524-525_Dormont_et_al_EN.pdf
    Download Restriction: no
    File URL: https://libkey.io/https://doi.org/10.24187/ecostat.2021.524d.2045?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. repec:dau:papers:123456789/1624 is not listed on IDEAS
    2. Kleibergen, Frank & Paap, Richard, 2006. "Generalized reduced rank tests using the singular value decomposition," Journal of Econometrics, Elsevier, vol. 133(1), pages 97-126, July.
    3. Jasmin Kantarevic & Boris Kralj, 2013. "Link Between Pay For Performance Incentives And Physician Payment Mechanisms: Evidence From The Diabetes Management Incentive In Ontario," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1417-1439, December.
    4. B. Dormont & A.‐L. Samson, 2008. "Medical demography and intergenerational inequalities in general practitioners' earnings," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1037-1055, September.
    5. Carine Franc & Romain Lesur, 2004. "Systèmes de rémunération des médecins et incitations à la prévention," Revue économique, Presses de Sciences-Po, vol. 55(5), pages 901-922.
    6. Cragg, John G. & Donald, Stephen G., 1993. "Testing Identifiability and Specification in Instrumental Variable Models," Econometric Theory, Cambridge University Press, vol. 9(2), pages 222-240, April.
    7. Eijkenaar, Frank & Emmert, Martin & Scheppach, Manfred & Schöffski, Oliver, 2013. "Effects of pay for performance in health care: A systematic review of systematic reviews," Health Policy, Elsevier, vol. 110(2), pages 115-130.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lin, Tracy Kuo & Werner, Kalin & Witter, Sophie & Alluhidan, Mohammed & Alghaith, Taghred & Hamza, Mariam M. & Herbst, Christopher H. & Alazemi, Nahar, 2022. "Individual performance-based incentives for health care workers in Organisation for Economic Co-operation and Development member countries: a systematic literature review," Health Policy, Elsevier, vol. 126(6), pages 512-521.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Coulibaly, Aïssata & Yogo, Urbain Thierry, 2020. "The path to shared prosperity: Leveraging financial services outreach to create decent jobs in developing countries," Economic Modelling, Elsevier, vol. 87(C), pages 131-147.
    2. Gillingham, Kenneth & Huang, Pei, 2021. "Racial disparities in the health effects from air pollution: Evidence from ports," ZEW Discussion Papers 21-058, ZEW - Leibniz Centre for European Economic Research.
    3. Berning, Joshua P., 2012. "Access to Local Agriculture and Weight Outcomes," Agricultural and Resource Economics Review, Northeastern Agricultural and Resource Economics Association, vol. 41(1), pages 1-15, April.
    4. Sanderson, Eleanor & Windmeijer, Frank, 2016. "A weak instrument F-test in linear IV models with multiple endogenous variables," Journal of Econometrics, Elsevier, vol. 190(2), pages 212-221.
    5. van der Ploeg, Frederick & Poelhekke, Steven, 2010. "The pungent smell of "red herrings": Subsoil assets, rents, volatility and the resource curse," Journal of Environmental Economics and Management, Elsevier, vol. 60(1), pages 44-55, July.
    6. Panayotis Constantinou & Jonathan Sicsic & Carine Franc, 2017. "Effect of pay-for-performance on cervical cancer screening participation in France," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 181-201, June.
    7. Bayar, Omer, 2018. "Weak instruments and estimated monetary policy rules," Journal of Macroeconomics, Elsevier, vol. 58(C), pages 308-317.
    8. Keita, Moussa, 2012. "Impact of subsidized inputs credits on land allocation and market-oriented agriculture in rural households in Mali," MPRA Paper 57542, University Library of Munich, Germany.
    9. Dachs, Bernhard & Peters, Bettina, 2014. "Innovation, employment growth, and foreign ownership of firms," Research Policy, Elsevier, vol. 43(1), pages 214-232.
    10. Dorgyles C.M. Kouakou, 2024. "The effect of informal competition on registered firms’ credit constraints: Global evidence, channels, and the roles of productivity and financial development," Economics Working Paper Archive (University of Rennes & University of Caen) 2024-10, Center for Research in Economics and Management (CREM), University of Rennes, University of Caen and CNRS.
    11. Miaojie Yu, 2010. "Processing Trade, Firm's Productivity, and Tariff Reductions : Evidence from Chinese Products," Macroeconomics Working Papers 22799, East Asian Bureau of Economic Research.
    12. Festic, Mejra & Kavkler, Alenka & Repina, Sebastijan, 2011. "The macroeconomic sources of systemic risk in the banking sectors of five new EU member states," Journal of Banking & Finance, Elsevier, vol. 35(2), pages 310-322, February.
    13. Alexakis, Christos & Kenourgios, Dimitris & Pappas, Vasileios & Petropoulou, Athina, 2021. "From dotcom to Covid-19: A convergence analysis of Islamic investments," Journal of International Financial Markets, Institutions and Money, Elsevier, vol. 75(C).
    14. Mejra Festić, 2011. "The role of the foreign banks in the 5 EU member states," Journal of Business Economics and Management, Taylor & Francis Journals, vol. 13(1), pages 189-206, June.
    15. Brogaard, Jonathan & Hendershott, Terrence & Riordan, Ryan, 2017. "High frequency trading and the 2008 short-sale ban," Journal of Financial Economics, Elsevier, vol. 124(1), pages 22-42.
    16. Werner, Dan, 2014. "Electricity Market Price Volatility: The Importance of Ramping Costs," 2014 Annual Meeting, July 27-29, 2014, Minneapolis, Minnesota 169619, Agricultural and Applied Economics Association.
    17. Eva Luthi & Kurt Schmidheiny, 2014. "The effect of agglomeration size on local taxes," Journal of Economic Geography, Oxford University Press, vol. 14(2), pages 265-287.
    18. Francis Tsiboe & Yacob A. Zereyesus & Jennie S. Popp & Evelyn Osei, 2018. "The Effect of Women’s Empowerment in Agriculture on Household Nutrition and Food Poverty in Northern Ghana," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 138(1), pages 89-108, July.
    19. Giorgio d'Agostino & Luca Pieroni & Margherita Scarlato, 2018. "Further evidence of the relationship between social transfers and income inequality in OECD countries," Working Papers 482, ECINEQ, Society for the Study of Economic Inequality.
    20. Lee, Junyong & Oh, Frederick Dongchuhl & Shin, Donglim, 2024. "Religion and corporate innovation," Journal of Multinational Financial Management, Elsevier, vol. 72(C).

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nse:ecosta:ecostat_2021_524d_2. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Veronique Egloff (email available below). General contact details of provider: https://edirc.repec.org/data/inseefr.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.