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Asymétries d'information et incertitude en santé : les apports de la théorie des contrats

  • Lise Rochaix

[fre] Asymétries d'information et incertitude en santé : les apports de la théorie des contrats . par Lise Rochaix . Le caractère imparfait, voire asymétrique, de l'information dont dispose le patient conduit à remettre en cause l'utilisation du modèle néoclassique standard et à appliquer les modèles micro-économiques de type Principal - Agent. L'objet de cet article est de dresser un bilan des applications récentes au secteur de la santé de la théorie des contrats. Si cette dernière offre une grille de lecture pertinente, elle est toutefois demeurée peu opérationnelle, essentiellement en raison de la fragmentation des décisions sur le marché des soins. Il convient donc de s'interroger sur la portée et les limites de ce type d'approche. Cette démarche apparaît d'autant plus importante que de nouvelles familles de modèles théoriques, de type multi-principaux, multi-agents ou avec tiers offrent aujourd'hui des perspectives rénovées d'application au champ de la santé. [eng] Information Asymmetry and Health Uncertainty: The Contribution of Contract Theory . by Lise Rochaix . The imperfect and even asymmetric nature of the information at the patient's disposal calls into question the use of the standard neo-classical model and has led to application of microeconomic principal-agent models. This paper sets out to assess recent applications of contract theory to the health sector. Although the latter offers a relevant model of interpretation, it is still of relatively little use, mainly because of the fragmentation of decisions relating to the health-care market. The scope and limitations of such an approach must therefore be examined. This is all the more important in that new families of theoretical models involving multiple principals, multiple agents or third parties are now offering fresh angles of application to the field of health.

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Article provided by Programme National Persée in its journal Économie & prévision.

Volume (Year): 129 (1997)
Issue (Month): 3 ()
Pages: 11-24

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Handle: RePEc:prs:ecoprv:ecop_0249-4744_1997_num_129_3_5861
Note: DOI:10.3406/ecop.1997.5861
Contact details of provider: Web page: http://www.persee.fr/web/revues/home/prescript/revue/ecop

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  1. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
  2. Mark Pauly, 1980. "Doctors and Their Workshops: Economic Models of Physician Behavior," NBER Books, National Bureau of Economic Research, Inc, number paul80-1, August.
  3. Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, vol. 26(2), pages 281-98, April.
  4. Laffont, J.J. & Martimort, D., 1995. "Collusion and Delegation," Papers 95.397, Toulouse - GREMAQ.
  5. Hay, Joel & Leahy, Michael J., 1982. "Physician-induced demand : An empirical analysis of the consumer information gap," Journal of Health Economics, Elsevier, vol. 1(3), pages 231-244, December.
  6. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
  7. Florence Naegelen & Michel Mougeot, 1997. "La réglementation hospitalière : tarification par pathologie ou achat de soins ?," Économie et Prévision, Programme National Persée, vol. 129(3), pages 207-220.
  8. Chalkley, M. & Malcomson, J.M., 1995. "Contracting for health services with unmonitored quality," Discussion Paper Series In Economics And Econometrics 9510, Economics Division, School of Social Sciences, University of Southampton.
  9. Gaynor, Martin, 1994. "Issues in the Industrial Organization of the Market for Physician Services," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 211-55, Spring.
  10. Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
  11. Mooney, Gavin & Ryan, Mandy, 1993. "Agency in health care: Getting beyond first principles," Journal of Health Economics, Elsevier, vol. 12(2), pages 125-135, July.
  12. Baron, David P & Besanko, David, 1987. "Commitment and Fairness in a Dynamic Regulatory Relationship," Review of Economic Studies, Wiley Blackwell, vol. 54(3), pages 413-36, July.
  13. Dionne, G. & Contandriopoulos, A.P., 1982. "Doctors and Their Workshops: a Review Article," Cahiers de recherche 8245, Universite de Montreal, Departement de sciences economiques.
  14. Mark Pauly, 1980. "Appendix to "Doctors and Their Workshops: Economic Models of Physician Behavior"," NBER Chapters, in: Doctors and Their Workshops: Economic Models of Physician Behavior, pages 119-122 National Bureau of Economic Research, Inc.
  15. Eeckhoudt, L. & Lebrun, T. & Sailly, J. C., 1985. "Risk-aversion and physicians' medical decision-making," Journal of Health Economics, Elsevier, vol. 4(3), pages 273-281, September.
  16. Stéphane Jacobzone & Lise Rochaix, 1997. "L'hypothèse de demande induite : un bilan économique," Économie et Prévision, Programme National Persée, vol. 129(3), pages 25-36.
  17. Bernheim, B Douglas & Whinston, Michael D, 1986. "Common Agency," Econometrica, Econometric Society, vol. 54(4), pages 923-42, July.
  18. Rochaix, Lise, 1989. "Information asymmetry and search in the market for physicians' services," Journal of Health Economics, Elsevier, vol. 8(1), pages 53-84, March.
  19. Glazer, Jacob & McGuire, Thomas G, 1994. "Payer Competition and Cost Shifting in Health Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 71-92, Spring.
  20. Propper, Carol, 1995. "Agency and incentives in the NHS internal market," Social Science & Medicine, Elsevier, vol. 40(12), pages 1683-1690, June.
  21. Rubinstein, Ariel & Yaari, Menahem E., 1983. "Repeated insurance contracts and moral hazard," Journal of Economic Theory, Elsevier, vol. 30(1), pages 74-97, June.
  22. Fenn, Paul & Rickman, Neil & McGuire, Alistair, 1994. "Contracts and supply assurance in the UK health care market," Journal of Health Economics, Elsevier, vol. 13(2), pages 125-144, July.
  23. Glenn M. MacDonald, 1984. "New Directions in the Economic Theory of Agency," Canadian Journal of Economics, Canadian Economics Association, vol. 17(3), pages 415-40, August.
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