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Premier bilan de la T2A sur la variabilité des coûts hospitaliers

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  • Carine Milcent

    () (PSE - Paris School of Economics - ENPC - École des Ponts ParisTech - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique - EHESS - École des hautes études en sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

Abstract

Ce papier étudie la variabilité des coûts hospitaliers pour des séjours comparables en pathologies et en procédures (GHM). A l'époque du budget global, une forte variabilité des coûts était observée entre les hôpitaux publics français. Qu'en est - il aujourd'hui ? Théoriquement, la T2A conduit les établissements à minimiser leurs coûts pour gagner la différence entre le forfait et le coût. Nous montrons une certaine homogénéisation des coûts et à une réelle prise en compte de l'hétérogénéité des individus. Les forfaits par GHM ne capturent cependant pas toute l'hétérogénéité entre les établissements, ni entre les patients. Ainsi, les effets néfastes de sélection des patients ou de diminution du niveau de qualité ne sont pas évités par les forfaits actuels.

Suggested Citation

  • Carine Milcent, 2017. "Premier bilan de la T2A sur la variabilité des coûts hospitaliers," PSE Working Papers halshs-01649554, HAL.
    • Handle: RePEc:hal:psewpa:halshs-01649554
    Note: View the original document on HAL open archive server: https://halshs.archives-ouvertes.fr/halshs-01649554
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    File URL: https://halshs.archives-ouvertes.fr/halshs-01649554/document
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    References listed on IDEAS

    as
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