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Le coût unitaire de l'activité hospitalière publique en 1997 : le poids des déterminants régionaux


  • Didier Balsan


[eng] The unit cost of hospital activity, measured by the value of the synthetic activity index, appears to vary substantially among hospitals, which are financed though lump sum transfers. The aim of the papers is to identify elements able to explain this variability, as such as activity indicators of the establishments (ratio of non medical personnel, dispersion of activity, gravity of the stays) and environmental indicators (regional value of the index, rate of unemployment and life expectancy). The estimated model gives a two-step like determination of the synthetic activity index of the establishments. First, the regional value of the index is determined by care supply and demand factors; the ratio of non medical personnel appears to depend on the one hand the size and the category of the establishments, and on the other hand on the index of average seriousness of the stays. Second, factors specific to the establishments (size and statute, dispersion of medical activity) are added the regional index value and to the ratio of non medical personnel in order to explain the index values of the establishments. [fre] Le coût unitaire de l'activité hospitalière, mesuré par la valeur du point d'indice synthétique d'activité, est fortement variable pour les établissements hospitaliers financés sous dotation globale. Dans le but d'isoler les facteurs de cette variabilité, on recourt à des indicateurs des caractéristiques de l'activité des établissements (ratio de personnel non médical, dispersion de l'activité, gravité des séjours) et de leur environnement (valeur régionale du point, taux de chômage et espérance de vie). Le modèle estimé donne l'image d'une détermination de la valeur du point des établissements en deux étapes. A un premier niveau, la valeur régionale du point est déterminée par des facteurs d'offre et de demande de soins ; le ratio de personnel non médical apparaît comme dépendant de la taille et de la catégorie des établissements et de l'indice de gravité moyenne des séjours. A un second niveau, des facteurs spécifiques aux établissements (taille et statut, dispersion de l'activité médicale) s'ajoutent à cette valeur régionale et au ratio de personnel non médical pour expliquer la valeur du point des établissements.

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  • Didier Balsan, 2002. "Le coût unitaire de l'activité hospitalière publique en 1997 : le poids des déterminants régionaux," Revue Française d'Économie, Programme National Persée, vol. 17(2), pages 101-115.
  • Handle: RePEc:prs:rfreco:rfeco_0769-0479_2002_num_17_2_1462
    Note: DOI:10.3406/rfeco.2002.1462

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    References listed on IDEAS

    1. Hervé Leleu & Benoît Dervaux, 1997. "Comparaison des différentes mesures d'efficacité technique : une application aux centres hospitaliers français," Économie et Prévision, Programme National Persée, vol. 129(3), pages 101-119.
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