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Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé

  • Wittwer, Jérôme
  • Dourgnon, Paul
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    Although horizontal equity is considered a universal guiding principle in socialized health systems, most of the countries where such systems are implemented show social inequalities in health care services consumption.This thesis brings together four studies. It aims at contributing to the analyses of health system reforms regarding equity in access to health care services.The introduction provides a description of social inequalities in health care services consumption in France as well as of the main mechanisms which, inside the French health system, can give rise to these inequalities.In the first chapter we study the links between financial barriers in accessing healthcare and health status. We show that unmet needs for financial reasons are associated with worse future health status.The second chapter proposes an analysis of the doctor-patient interaction and how it can affects inequalities in health care consumption. We first study the categorizations operated by the doctors about their patients according to the patients’ socioeconomic status. We then study how these categorizations interact with observed practices patterns.The third chapter brings together two analyses of the “preferred doctor reform”. A first study analyses the reform and its context, with a focus on the role of the stakeholders. A second study investigates the consequences of the reform on financial access to specialist care.

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    File URL: http://basepub.dauphine.fr/xmlui/bitstream/123456789/12221/1/2013PA090009.pdf
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    This book is provided by Paris Dauphine University in its series Economics Thesis from University Paris Dauphine with number 123456789/12221 and published in 2013.
    Order: http://basepub.dauphine.fr/xmlui/handle/123456789/12221
    Handle: RePEc:dau:thesis:123456789/12221
    Note: dissertation
    Contact details of provider: Web page: http://www.dauphine.fr/en/welcome.html

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    1. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May.
    2. Jusot, Florence & Sermet, Catherine & Devaux, Marion & Tubeuf, Sandy, 2008. "Social heterogeneity in self-reported health status and measurement of inequalities in health," Economics Papers from University Paris Dauphine 123456789/7004, Paris Dauphine University.
    3. Dourgnon, Paul & Jusot, Florence & Fantin, Romain, 2012. "Payer nuit gravement à la santé : une étude de l’impact du renoncement financier aux soins sur l’état de santé," Economics Papers from University Paris Dauphine 123456789/12236, Paris Dauphine University.
    4. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687.
    5. Allin, Sara & Grignon, Michel & Le Grand, Julian, 2010. "Subjective unmet need and utilization of health care services in Canada: What are the equity implications?," Social Science & Medicine, Elsevier, vol. 70(3), pages 465-472, February.
    6. Fantin, Romain & Jusot, Florence & Dourgnon, Paul, 2011. "Payer peut nuire à votre santé : une étude de l’impact du renoncement financier aux soins sur l’état de santé," Economics Papers from University Paris Dauphine 123456789/9215, Paris Dauphine University.
    7. Michel Naiditch & Paul Dourgnon, 2009. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Working Papers DT22, IRDES institut for research and information in health economics, revised Mar 2009.
    8. Michel Grignon & Marc Perronnin & John N. Lavis, 2008. "Does free complementary health insurance help the poor to access health care? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 203-219.
    9. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
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