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Santé, environnement et consommations médicales. Discussion autour d'un modèle

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  • Alain Letourmy

Abstract

[fre] L'évaluation de l'impact sanitaire global de la consommation médicale constitue un problème controversé qu'il est utile d'aborder à travers la formulation de l'estimation d'un modèle économétrique. On construit celui-ci à partir d'hypothèses simples tirées de la littérature socio-économique ou épidérniologique et on l'adapte ensuite à un contexte empirique particulier, celui des départements français en 1968, en représentant l'état de santé d'une population par ses conditions de mortalité. L'estimation du modèle met en avant le rôle du mode de vie, et plus généralement de l'environnement, dans la formation du niveau de mortalité d'un département, à laquelle ne participent pratiquement pas les soins médicaux. Simultanément, la consommation de soins paraît surtout dépendre de l'infrastructure médicale disponible. On discute ensuite quelques points critiques inhérents à la démarche suivie, notamment la représentation de l'état de santé par la mortalité. On parvient enfin à promouvoir une conception plus complète du problème d'évalution des effets des soins dans laquelle s'intègrent les résultats du présent modèle, et à proposer une approche renouvelée — moins technique — des questions de santé. [eng] Health, environment al factors and medical care. . The overall évaluation of the effectiveness of medical care represents a controversial matter, which can be usefully dealt with by means of an cconometric model. The formulation of the model is based on simple assumptions, drawn from socio-economie and epidemiological studies ; its Framework is fitted to specifie data, that give a cross-sectional description of french " departements " in 1968 ; heatth status is represented by mortality data. The estimation stresses on environmental factors as determinants of the mortality level, which is practically not influenced by medical care. Simultaneously the main determinants of medical care seem to be the available medical facilities. Then, some critical points of the empirical investigation are discussed, especially the use of mortality level as health status index. Finally a more complete conception of health problems is suggested, particularly about the evaluation of the effectiveness of medical care ; the results found in the model appear to justify this new — and less technical — approach.

Suggested Citation

  • Alain Letourmy, 1976. "Santé, environnement et consommations médicales. Discussion autour d'un modèle," Revue Économique, Programme National Persée, vol. 27(3), pages 402-432.
  • Handle: RePEc:prs:reveco:reco_0035-2764_1976_num_27_3_408268
    Note: DOI:10.3406/reco.1976.408268
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    1. Richard Auster & Irving Leveson & Deborah Sarachek, 1969. "The Production of Health, an Exploratory Study," Journal of Human Resources, University of Wisconsin Press, vol. 4(4), pages 411-436.
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