IDEAS home Printed from
   My bibliography  Save this book

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


  • Wittwer, Jérôme


  • Dourgnon, Paul


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.

Suggested Citation

  • Dourgnon, Paul, 2013. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/12221 edited by Wittwer, Jérôme, April.
  • Handle: RePEc:dau:thesis:123456789/12221
    Note: dissertation

    Download full text from publisher

    File URL:
    Download Restriction: no

    References listed on IDEAS

    1. 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.
    2. Sandy Tubeuf & Florence Jusot & Marion Devaux & Catherine Sermet, 2008. "Social heterogeneity in self-reported health status and measurement of inequalities in health," Working Papers DT12, IRDES institut for research and information in health economics, revised Jun 2008.
    3. 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.
    4. Dourgnon, Paul & Naiditch, Michel, 2010. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Health Policy, Elsevier, vol. 94(2), pages 129-134, February.
    5. Paul Dourgnon & Florence Jusot & Romain Fantin, 2012. "Payer peut nuire à votre santé : une étude de l’impact du renoncement financier aux soins sur l’état de santé," Working Papers DT47, IRDES institut for research and information in health economics, revised Apr 2012.
    6. 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.
    7. repec:dau:papers:123456789/12236 is not listed on IDEAS
    8. repec:dau:papers:123456789/7004 is not listed on IDEAS
    9. 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.
    10. 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.
    Full references (including those not matched with items on IDEAS)

    More about this item


    Économie de la santé; Inégalités sociales de santé; Évaluation des politiques publiques; Health economics; Social heath inequalities; Policy evaluation;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health


    Access and download statistics


    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:dau:thesis:123456789/12221. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Alexandre Faure). General contact details of provider: .

    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 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.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.