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Concurrence et incitations dans le système hospitalier

  • Michel Mougeot

[fre] Après avoir mis en évidence les problèmes posés aux systèmes de santé par la conjonction de l'incertitude et de l'asymétrie d'information, cet article analyse certains mécanismes incitatifs ayant pour but la maîtrise des dépenses. Une première partie est consacrée à des règles instaurant une concurrence fictive entre offreurs : politique d'enveloppe globale et tarification en fonction d'une moyenne. La seconde partie analyse les procédures de concurrence organisée : enchères mises en place par des acheteurs de soins (P.P.O., A.H.C.C.S. aux États-Unis, livre blanc anglais), organisation d'une concurrence des offreurs et des assureurs (H.M.O., plan Dekker). [eng] Michel Mougeot Competition and incentives in the health care system. This paper analyses the consequences of uncertainty and asymmetric information on the organisation of health care system. It considers the implementation of incentive mechanisms in some countries. In the first part, the author analyses the fictitious competition mechanisms : global envelope policy, yardstick competition. In the second part, he studies the competitive bidding mechanisms (P. P.O. or A.H.C.C.S. in the United States, tender procedures in the «working for patient» project in the United Kindom, Dekker plan in the Nether- land, H.M.O.).

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File URL: http://dx.doi.org/10.3406/rfeco.1993.930
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File URL: http://www.persee.fr/articleAsPDF/rfeco_0769-0479_1993_num_8_2_930/rfeco_0769-0479_1993_num_8_2_930.pdf?mode=light
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Article provided by Programme National Persée in its journal Revue française d'économie.

Volume (Year): 8 (1993)
Issue (Month): 2 ()
Pages: 109-131

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Handle: RePEc:prs:rfreco:rfeco_0769-0479_1993_num_8_2_930
Note: DOI:10.3406/rfeco.1993.930
Contact details of provider: Web page: http://www.persee.fr/web/revues/home/prescript/revue/rfeco

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