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Hospital payment systems: Taking heterogeneity into account
[Tarification des hôpitaux : la prise en compte des hétérogénéités]


  • Brigitte Dormont

    (Institute of Health Economics and Management - Institute of Health Economics and Management)

  • Carine Milcent

    () (PJSE - Paris-Jourdan Sciences Economiques - ENS Paris - École normale supérieure - Paris - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique)


ABSTRACT.-The purpose of this paper is to study hospital costs in the event of introduction of a Prospective Payment System in France. We use a nested three dimensional database (stays-hospitals-years) to identify hospital unobservable heterogeneity and a transitory moral hazard component of cost variability. Transitory moral hazard is about 50% of the standard error we estimate for cost variability due to permanent unobervable heterogeneity between hospitals. Simulations show that a cost reduction of about 16% can be expected from implementation of a payment system which allows for permanent unobserved heterogeneity and eliminates only transitory moral hazard. Cette étude a été financée en partie par une convention avec la DREES (Ministère de l'emploi et de la solidarité). Nous remercions Werner ANTWEILER (University of British Columbia) pour ses précieux commentaires, ainsi que Bruno CRÉPON, Alberto HOLLY, Nathalie DESTAIS et les deux rapporteurs anonymes de la revue. Nous avons aussi pro-fité des remarques des participants du séminaire santé CREST-LEI, du séminaire Théma, du séminaire FOURGEAUD et du Summer Workshop du NBER (Boston [2002]).

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  • Brigitte Dormont & Carine Milcent, 2004. "Hospital payment systems: Taking heterogeneity into account
    [Tarification des hôpitaux : la prise en compte des hétérogénéités]
    ," Post-Print halshs-01990505, HAL.
  • Handle: RePEc:hal:journl:halshs-01990505
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