IDEAS home Printed from https://ideas.repec.org/a/prs/ecstat/estat_0336-1454_2012_num_455_1_10020.html

Stratégies de localisation des médecins généralistes français : mécanismes économiques ou hédonistes ?

Author

Listed:
  • Eric Delattre
  • Anne-Laure Samson

Abstract

En France, la densité médicale est élevée mais les médecins généralistes sont très inégalement répartis sur le territoire. Parce qu'elle renvoie à des questions d'équité et d'efficacité, cette mauvaise répartition constitue aujourd'hui un enjeu majeur de la régulation de la démographie médicale. Un échantillon exhaustif de 9 000 médecins généralistes ayant débuté leur carrière libérale entre 1997 et 2002 est mobilisé afin d'analyser les déterminants des choix individuels de localisation des médecins généralistes et, ainsi, de rendre compte des outils qui pourraient être utilisés spécifiquement au niveau régional pour modifier leurs comportements de localisation. Nous modélisons deux décisions : le choix du changement de région entre la date de la soutenance de la thèse et l'installation et le choix de la région d'exercice pour les seuls médecins qui quittent la région où ils ont soutenu leur thèse. Au travers de ces choix individuels, nous étudions en particulier l'attractivité monétaire des régions afin de déterminer dans quelle mesure les comportements des médecins pourraient être influencés par l'instauration de primes à l'installation dans les zones sous-dotées en médecins. Nous observons un comportement marqué de sédentarité chez les médecins, qui s'installent en grande majorité dans la région de leur thèse. Les politiques doivent donc être orientées, en priorité, vers les étudiants en médecine. Nous montrons par ailleurs que les politiques d'incitation financière à l'installation dans des zones sous-dotées en médecins seraient susceptibles d'influencer la localisation des médecins, même si la modification de la répartition qui en résulterait serait quantitativement d'une faible ampleur. En effet, les primes devraient être d'un montant très élevé pour compenser la perte de qualité de vie consentie par les médecins. Les mécanismes financiers incitatifs ne peuvent donc pas être les seuls leviers de correction des inégalités de répartition des médecins.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Eric Delattre & Anne-Laure Samson, 2012. "Stratégies de localisation des médecins généralistes français : mécanismes économiques ou hédonistes ?," Économie et Statistique, Programme National Persée, vol. 455(1), pages 115-142.
    • Handle: RePEc:prs:ecstat:estat_0336-1454_2012_num_455_1_10020
    DOI: 10.3406/estat.2012.10020
    Note: DOI:10.3406/estat.2012.10020
    as

    Download full text from publisher

    File URL: https://doi.org/10.3406/estat.2012.10020
    Download Restriction: no
    File URL: https://www.persee.fr/doc/estat_0336-1454_2012_num_455_1_10020
    Download Restriction: no
    File URL: https://libkey.io/10.3406/estat.2012.10020?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. Horev, Tuvia & Pesis-Katz, Irena & Mukamel, Dana B., 2004. "Trends in geographic disparities in allocation of health care resources in the US," Health Policy, Elsevier, vol. 68(2), pages 223-232, May.
    2. Denis Bolduc & Bernard Fortin & Stephen Gordon, 1997. "Multinomial Probit Estimation of Spatially Interdependent Choices: An Empirical Comparison of Two New Techniques," International Regional Science Review, , vol. 20(1-2), pages 77-101, April.
    3. Brigitte Dormont & Anne-Laure Samson, 2008. "Démographie médicale et carrières des médecins généralistes : les inégalités entre générations," Économie et Statistique, Programme National Persée, vol. 414(1), pages 3-30.
    4. Eric Delattre & Brigitte Dormont, 2003. "Fixed fees and physician‐induced demand: A panel data study on French physicians," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 741-754, September.
    5. Roback, Jennifer, 1982. "Wages, Rents, and the Quality of Life," Journal of Political Economy, University of Chicago Press, vol. 90(6), pages 1257-1278, December.
    6. Bolduc, Denis & Fortin, Bernard & Fournier, Marc-Andre, 1996. "The Effect of Incentive Policies on the Practice Location of Doctors: A Multinomial Probit Analysis," Journal of Labor Economics, University of Chicago Press, vol. 14(4), pages 703-732, October.
    7. Steven Simoens & Jeremy Hurst, 2006. "The Supply of Physician Services in OECD Countries," OECD Health Working Papers 21, OECD Publishing.
    8. repec:dau:papers:123456789/1637 is not listed on IDEAS
    9. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521747387.
    10. Dionne, Georges & Langlois, Alain & Lemire, Nicole, 1987. "More on the geographical distribution of physicians," Journal of Health Economics, Elsevier, vol. 6(4), pages 365-374, December.
    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. repec:hal:journl:hal-01297576 is not listed on IDEAS
    2. Magali Dumontet & Carine Franc, 2015. "Gender differences in French GPs’ activity: the contribution of quantile regressions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(4), pages 421-435, May.
    3. Jean-Baptiste Simon Combes & Alain Paraponaris & Yann Videau, 2019. "French GPs’ willingness to delegate tasks: may financial incentives balance risk aversion?," Erudite Working Paper 2019-09, Erudite.
    4. Matthieu Cassou & Julien Mousquès & Carine Franc, 2020. "General practitioners’ income and activity: the impact of multi-professional group practice in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1295-1315, December.
    5. Thomas Barnay & Carine Franc & Florence Jusot, 2015. "Introduction générale. La santé et les soins : prise en charge, déterminants sociaux, conséquences professionnelles," Post-Print hal-02431053, HAL.
    6. Thomas Barnay & Carine Franc & Florence Jusot, 2015. "Introduction : La santé et les soins : prise en charge, déterminants sociaux, conséquences professionnelles," Économie et Statistique, Programme National Persée, vol. 475(1), pages 17-29.

    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. repec:dau:papers:123456789/11295 is not listed on IDEAS
    2. Holmes, George M., 2005. "Increasing physician supply in medically underserved areas," Labour Economics, Elsevier, vol. 12(5), pages 697-725, October.
    3. Isabel Correia & Paula Veiga, 2022. "Correction to: Geographic distribution of physicians in Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1257-1257, September.
    4. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    5. Probst, Markus, 2021. "Ohne Moos nichts los? Eine Discrete-Choice-Analyse der Präferenzen von Medizinstudenten für die Arbeit auf dem Land [No Mon, No Fun? A Discrete Choice Analysis of the Preferences of Medical Students for Work on the Countryside]," Junior Management Science (JUMS), Junior Management Science e. V., vol. 6(3), pages 507-546.
    6. Wang, Chih-Hao & Chen, Na, 2015. "A GIS-based spatial statistical approach to modeling job accessibility by transportation mode: case study of Columbus, Ohio," Journal of Transport Geography, Elsevier, vol. 45(C), pages 1-11.
    7. Bhat, Chandra R., 2011. "The maximum approximate composite marginal likelihood (MACML) estimation of multinomial probit-based unordered response choice models," Transportation Research Part B: Methodological, Elsevier, vol. 45(7), pages 923-939, August.
    8. Plantinga, Andrew J. & Détang-Dessendre, Cécile & Hunt, Gary L. & Piguet, Virginie, 2013. "Housing prices and inter-urban migration," Regional Science and Urban Economics, Elsevier, vol. 43(2), pages 296-306.
    9. Weiss, Adam & Habib, Khandker Nurul, 2017. "Examining the difference between park and ride and kiss and ride station choices using a spatially weighted error correlation (SWEC) discrete choice model," Journal of Transport Geography, Elsevier, vol. 59(C), pages 111-119.
    10. Mu, Chunzhou, 2015. "The age profile of the location decision of Australian general practitioners," Social Science & Medicine, Elsevier, vol. 142(C), pages 183-193.
    11. HOSHI, Kisho, 2023. "New Medical Schools, Access to Doctors and Health Outcomes : Evidence from Japan," CEI Working Paper Series 2023-05, Center for Economic Institutions, Institute of Economic Research, Hitotsubashi University.
    12. Reinhard A. Weisser, 2020. "How Personality Shapes Study Location Choices," Research in Higher Education, Springer;Association for Institutional Research, vol. 61(1), pages 88-116, February.
    13. Bernard Fortin & Justin Ndoutoumou & Josette Gbeto & Maude Laberge, 2025. "Impact des mesures incitatives et coercitives sur le lieu de pratique des nouveaux médecins de famille," CIRANO Project Reports 2025rp-02, CIRANO.
    14. Friederike Paetz & Winfried J. Steiner, 2017. "The benefits of incorporating utility dependencies in finite mixture probit models," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 39(3), pages 793-819, July.
    15. Liu, Zhaoyang & Hanley, Nick & Campbell, Danny, 2020. "Linking urban air pollution with residents’ willingness to pay for greenspace: A choice experiment study in Beijing," Journal of Environmental Economics and Management, Elsevier, vol. 104(C).
    16. Stéphanie Truchet & Nicolas Mauhe & Marie Herve, 2017. "Veterinarian shortage areas: what determines the location of new graduates?," Review of Agricultural, Food and Environmental Studies, Springer, vol. 98(4), pages 255-282, December.
    17. Daziano, Ricardo A., 2015. "Inference on mode preferences, vehicle purchases, and the energy paradox using a Bayesian structural choice model," Transportation Research Part B: Methodological, Elsevier, vol. 76(C), pages 1-26.
    18. Abildtrup, Jens & Garcia, Serge & Olsen, Søren Bøye & Stenger, Anne, 2013. "Spatial preference heterogeneity in forest recreation," Ecological Economics, Elsevier, vol. 92(C), pages 67-77.
    19. Gustavo Ahumada & Victor Iturra & Mauricio Sarrias, 2020. "We Do Not Have the Same Tastes! Evaluating Individual Heterogeneity in the Preferences for Amenities," Journal of Happiness Studies, Springer, vol. 21(1), pages 53-74, January.
    20. Sener, Ipek N. & Pendyala, Ram M. & Bhat, Chandra R., 2011. "Accommodating spatial correlation across choice alternatives in discrete choice models: an application to modeling residential location choice behavior," Journal of Transport Geography, Elsevier, vol. 19(2), pages 294-303.
    21. Charles Nathanson, 2019. "Trickle-Down Housing Economics," 2019 Meeting Papers 537, Society for Economic Dynamics.

    More about this item

    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:prs:ecstat:estat_0336-1454_2012_num_455_1_10020. 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: Equipe PERSEE (email available below). General contact details of provider: https://www.persee.fr/collection/estat .

    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.