IDEAS home Printed from https://ideas.repec.org/p/irh/wpaper/dt51.html
   My bibliography  Save this paper

L'Accessibilité potentielle localisée (APL) : une nouvelle mesure de l'accessibilité aux soins appliquée aux médecins généralistes libéraux en France

Author

Listed:
  • Muriel Barlet

    () (DREES Direction de la recherche des études de l'évaluation et des statistiques)

  • Magali Coldefy

    () (IRDES Institute for research and information in health economics)

  • Clémentine Collin

    () (DREES Direction de la recherche des études de l'évaluation et des statistiques)

  • Véronique Lucas Gabrielli

    () (IRDES Institute for research and information in health economics)

Abstract

Les soins de premiers recours jouent un rôle essentiel sur la santé de la population. En France, bien que la densité médicale soit l’une des plus élevées d’Europe, l’accessibilité aux soins est aujourd’hui un enjeu majeur des politiques de santé, du fait du rôle important accordé au médecin généraliste, de l’existence de disparités spatiales de l’offre de soins et des tendances démographiques à la baisse du nombre de médecins sur le court terme ainsi que des fortes attentes d’une population vieillissante aux besoins de soins élevés et à la mobilité réduite. Dans cette recherche, nous nous intéressons à la mesure de l’accessibilité spatiale au médecin généraliste. Profitant des récents développements en géographie de la santé sur les soins de premiers recours, nous proposons de construire un indicateur permettant de considérer simultanément l’offre, la demande de soins et l’accès aux soins, en nous appuyant sur la méthode du Two-step floating catchment area développée dans quelques pays anglophones. Nous l’adaptons ici au contexte des soins français et proposons quelques pistes d’amélioration dans trois dimensions principales : i) la définition et la quantification de l’offre de soins, ii) l’intégration du besoin de soins du côté de la demande, iii) une définition plus précise de l’interaction entre l’offre et la demande. Au final, l’indicateur d’Accessibilité potentielle localisée (APL) propose une approche renouvelée et améliorée de l’accès aux médecins généralistes libéraux, prenant en compte l’offre et la demande de soins à l’échelle de la commune. L’APL répond ainsi aux principales critiques faites aux indicateurs usuels d’accessibilité aux soins tout en restant relativement aisée à calculer dans la mesure où elle mobilise des données facilement disponibles. L’APL s’interprète comme une densité et constitue ainsi un outil complémentaire utile à l’observation et au pilotage de l’organisation des soins à un niveau local.

Suggested Citation

  • Muriel Barlet & Magali Coldefy & Clémentine Collin & Véronique Lucas Gabrielli, 2012. "L'Accessibilité potentielle localisée (APL) : une nouvelle mesure de l'accessibilité aux soins appliquée aux médecins généralistes libéraux en France," Working Papers DT51, IRDES institut for research and information in health economics, revised Dec 2012.
  • Handle: RePEc:irh:wpaper:dt51
    as

    Download full text from publisher

    File URL: http://www.irdes.fr/EspaceRecherche/DocumentsDeTravail/DT51AccessibilitePotentielleLocalisee.pdf
    File Function: First version, 2012
    Download Restriction: no

    References listed on IDEAS

    as
    1. Magnus Henrekson & Mats Persson, 2004. "The Effects on Sick Leave of Changes in the Sickness Insurance System," Journal of Labor Economics, University of Chicago Press, vol. 22(1), pages 87-114, January.
    2. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, pages 766-817.
    3. Barmby, Tim & Stephan, Gesine, 2000. "Worker Absenteeism: Why Firm Size May Matter," Manchester School, University of Manchester, vol. 68(5), pages 568-577, September.
    4. Olsson, Martin, 2009. "Employment protection and sickness absence," Labour Economics, Elsevier, vol. 16(2), pages 208-214, April.
    5. Sophie Guthmuller & Florence Jusot & Jérôme Wittwer & Caroline Despres, 2010. "Le recours à l’Aide complémentaire santé : les enseignements d’une expérimentation sociale à Lille," Working Papers DT36, IRDES institut for research and information in health economics, revised Dec 2010.
    6. Boyer, Marcel & Moreaux, Michel, 1989. "Endogenous Rationing in a Differentiated Product Duopoly," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 30(4), pages 877-888, November.
    7. Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.
    8. Jan Erik Askildsen & Espen Bratberg & Øivind Anti Nilsen, 2005. "Unemployment, labor force composition and sickness absence: a panel data study," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1087-1101.
    9. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2010. "Effort or Circumstances: Does the Correlation Matter for Inequality of Opportunity in Health?," Working Papers DT33, IRDES institut for research and information in health economics, revised Jul 2010.
    10. Luc Behaghel & Didier Blanchet & Thierry Debrand & Muriel Roger, 2012. "Disability and Social Security Reforms: The French Case," NBER Chapters,in: Social Security Programs and Retirement around the World: Historical Trends in Mortality and Health, Employment, and Disability Insurance Participatio, pages 301-326 National Bureau of Economic Research, Inc.
    11. Livanos, Ilias & Zangelidis, Alexandros, 2010. "Sickness Absence: a Pan-European Study," MPRA Paper 22627, University Library of Munich, Germany.
    12. Dionne, Georges & St-Michel, Pierre, 1991. "Workers' Compensation and Moral Hazard," The Review of Economics and Statistics, MIT Press, pages 236-244.
    13. Lazear, Edward P, 1979. "Why Is There Mandatory Retirement?," Journal of Political Economy, University of Chicago Press, vol. 87(6), pages 1261-1284, December.
    14. Mohamed Ali Ben Halima & Thierry Debrand & Camille Regaert, 2011. "Arrêts maladie : comprendre les disparités départementales," Working Papers DT39, IRDES institut for research and information in health economics, revised Feb 2011.
    15. Caroline Berchet & Nicolas Sirven, 2012. "Cross-Country Performance in Social Integration of Older Migrants. A European Perspective," Working Papers DT46, IRDES institut for research and information in health economics, revised Mar 2012.
    16. Sirven, Nicolas & Or, Zeynep, 2010. "Disparities in Regular Health Care Utilisation in Europe," MEA discussion paper series 10231, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
    17. Engellandt, Axel & Riphahn, Regina T., 2005. "Temporary contracts and employee effort," Labour Economics, Elsevier, pages 281-299.
    18. Barmby, Tim & Orme, Chris & Treble, John, 1995. "Worker absence histories: a panel data study," Labour Economics, Elsevier, vol. 2(1), pages 53-65, March.
    19. 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.
    20. Nicolas Sirven & Thierry Debrand, 2011. "Social Capital and Health of Older Europeans," Working Papers DT40, IRDES institut for research and information in health economics, revised Feb 2011.
    21. Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Economics and Management, Springer, pages 83-112.
    22. Arai, Mahmood & Thoursie, Peter Skogman, 2005. "Incentives and selection in cyclical absenteeism," Labour Economics, Elsevier, vol. 12(2), pages 269-280, April.
    23. Johansson, Per & Palme, Marten, 2005. "Moral hazard and sickness insurance," Journal of Public Economics, Elsevier, pages 1879-1890.
    24. Leigh, J. Paul, 1985. "The effects of unemployment and the business cycle on absenteeism," Journal of Economics and Business, Elsevier, pages 159-170.
    25. Paul Söderlind, 2010. "Reaction of Swiss Term Premia to Monetary Policy Surprises," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), pages 385-404.
    26. Puhani, Patrick A. & Sonderhof, Katja, 2010. "The effects of a sick pay reform on absence and on health-related outcomes," Journal of Health Economics, Elsevier, vol. 29(2), pages 285-302, March.
    27. Allan Little, 2009. "Spatial Pattern of Economic Activity and Inactivity in Britain: People or Place Effects?," Regional Studies, Taylor & Francis Journals, pages 877-897.
    28. Catherine Pollak & Nicolas Sirven, 2012. "Active Ageing Beyond the Labour Market: Evidence on Work Environment Motivations," Working Papers DT48, IRDES institut for research and information in health economics, revised May 2012.
    29. Bridges, Sarah & Mumford, Karen, 2001. "Absenteeism in the UK: A Comparison across Genders," Manchester School, University of Manchester, vol. 69(3), pages 276-284, June.
    30. Didier Blanchet & Thierry Debrand, 2007. "Souhaiter prendre sa retraite le plus tôt possible : santé, satisfaction au travail et facteurs monétaires," Économie et Statistique, Programme National Persée, vol. 403(1), pages 39-62.
    31. Michel Grignon & Thomas Renaud, 2007. "Sickness and injury leave in France: moral hazard or strain?," Working Papers DT4, IRDES institut for research and information in health economics, revised Feb 2007.
    32. Thierry Debrand & Christine Sorasith, 2010. "Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity," Working Papers DT34, IRDES institut for research and information in health economics, revised Nov 2010.
    33. Kuhn, Andreas & Lalive, Rafael & Zweimüller, Josef, 2009. "The public health costs of job loss," Journal of Health Economics, Elsevier, vol. 28(6), pages 1099-1115, December.
    34. Fahr, René & Frick, Bernd, 2007. "On the Inverse Relationship between Unemployment and Absenteeism: Evidence from Natural Experiments and Worker Heterogeneity," IZA Discussion Papers 3171, Institute for the Study of Labor (IZA).
    35. Thierry Debrand & Nicolas Sirven, 2009. "What are the Motivations of Pathways to Retirement in Europe: Individual, Familial, Professional Situation or Social Protection Systems?," Working Papers DT28, IRDES institut for research and information in health economics, revised Oct 2009.
    36. Allen, Steven G, 1981. "An Empirical Model of Work Attendance," The Review of Economics and Statistics, MIT Press, pages 77-87.
    37. Per Johansson & Mårten Palme, 2002. "Assessing the Effect of Public Policy on Worker Absenteeism," Journal of Human Resources, University of Wisconsin Press, vol. 37(2), pages 381-409.
    38. Marco G. Ercolani, 2006. "UK Employees' Sickness Absence: 1984-2005," Discussion Papers 06-02, Department of Economics, University of Birmingham.
    39. Dionne, Georges & St-Michel, Pierre, 1991. "Workers' Compensation and Moral Hazard," The Review of Economics and Statistics, MIT Press, pages 236-244.
    40. Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Economics and Management, Springer, pages 83-112.
    41. Carine Franc & Marc Perronnin & Aurélie Pierre, 2010. "Subscribing to Supplemental Health Insurance in France: A Dynamic Analysis of Adverse Selection," Working Papers DT35, IRDES institut for research and information in health economics, revised Dec 2010.
    42. Luiz Flavio Andrade, 2012. "Entry Time Effects and Follow-on Drugs Competition," Working Papers DT49, IRDES institut for research and information in health economics, revised Jun 2012.
    43. Shapiro, Carl & Stiglitz, Joseph E, 1984. "Equilibrium Unemployment as a Worker Discipline Device," American Economic Review, American Economic Association, pages 433-444.
    44. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, pages 766-817.
    45. Weiss, Andrew, 1985. "Absenteeism and wages," Economics Letters, Elsevier, vol. 19(3), pages 277-279.
    46. Catherine Pollak, 2012. "Employed and Happy despite Weak Health? Labour Market Participation and Job Quality of Older Workers with Disabilities," Working Papers DT45, IRDES institut for research and information in health economics, revised Mar 2012.
    47. Leigh, J. Paul, 1991. "Employee and job attributes as predictors of absenteeism in a national sample of workers: The importance of health and dangerous working conditions," Social Science & Medicine, Elsevier, pages 127-137.
    48. Mohamed Ali Ben Halima & Thierry Debrand, 2011. "Durée d’arrêt de travail, salaire et Assurance maladie : application microéconométrique à partir de la base Hygie," Working Papers DT42, IRDES institut for research and information in health economics, revised Sep 2011.
    49. Clément Nestrigue & Zeynep Or, 2012. "Estimation du surcoût des événements indésirables associés aux soins à l'hôpital en France," Working Papers DT44, IRDES institut for research and information in health economics, revised Feb 2012.
    50. Ose, Solveig Osborg, 2005. "Working conditions, compensation and absenteeism," Journal of Health Economics, Elsevier, vol. 24(1), pages 161-188, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Véronique Lucas-Gabrielli & Clément Nestrigue, 2016. "Analyse de sensibilité de l’Accessibilité potentielle localisée (APL)," Working Papers DT70, IRDES institut for research and information in health economics, revised Jan 2016.
    2. Guillaume Chevillard & Julien Mousquès & Véronique Lucas-Gabrielli & Yann Bourgueil & Stéphane Rican & Gérard Salem, 2013. "Maisons et pôles de santé : places et impacts dans les dynamiques territoriales d'offre de soins en France," Working Papers DT57, IRDES institut for research and information in health economics, revised Nov 2013.

    More about this item

    Keywords

    Primary care; Accessibility; France; General practitioner; Health care access; Distance; Health geography.;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • R53 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Regional Government Analysis - - - Public Facility Location Analysis; Public Investment and Capital Stock

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    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:irh:wpaper:dt51. 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: (Jacques Harrouin). General contact details of provider: http://edirc.repec.org/data/credefr.html .

    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.

    We have no references for this item. You can help adding them by using 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.