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Better Together? A Mediation Analysis of French General Practitioners’ Performance in Multi Professional Group Practice

Author

Listed:
  • Anna Zaytseva
  • Pierre Verger
  • Bruno Ventelou

Abstract

Background: Integrated primary care teams remain a debatable policy in family medicine that could be a convenient response to French shortages in medical density. Objectives: To analyse how general practitioners (GPs) respond to insufficient GP supply in their practice area in terms of quantity and quality of care, and how this response is mediated by enrolment in integrated primary care teams – multi-professional group practices (MGPs). Methods: We used structural equation modelling on 3 representative cross-sectional surveys (2019-2020) of 1209 French GPs. Quantity and quality of care were approximated by latent variables comprising respectively GPs’ demand absorption capacity and frequencies of vaccine recommendations. Results: In the absence of potential mediators, low GP density was negatively associated with quantity (−0.221, unstandardized direct effects), but not with the quality of care. In the presence of mediators, low GP density was associated with higher work-related stress (0.120), which was consecutively associated with deteriorated demand absorption capacity (−0.202). Higher use of e-health tools was associated with greater involvement in vaccine recommendations (0.357). GPs in MGPs tended to use more e-health tools than those practicing outside MGPs (0.032), with a favourable effect on vaccine recommendations. Conclusion: Lower level of work-related stress is the key mediator in handling patients’ requests. When correcting for self-selection into MGPs, we found no significant mediation effect of enrolment in MGPs on the quantity of care but rather an effect on the quality of care. Our results pinpoint an added value of an enrolment in an MGPs to care quality that advocates for its further development. JEL Classification: I14, I18

Suggested Citation

  • Anna Zaytseva & Pierre Verger & Bruno Ventelou, 2025. "Better Together? A Mediation Analysis of French General Practitioners’ Performance in Multi Professional Group Practice," ULB Institutional Repository 2013/390462, ULB -- Universite Libre de Bruxelles.
  • Handle: RePEc:ulb:ulbeco:2013/390462
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    References listed on IDEAS

    as
    1. Davin-Casalena, Bérengère & Scronias, Dimitri & Videau, Yann & Verger, Pierre, 2024. "How general practitioners in France are coping with increased healthcare demand and physician shortages. A panel data survey and hierarchical clustering," Health Policy, Elsevier, vol. 149(C).
    2. Eleonora Fichera & Mario Pezzino, 2017. "Pay for performance and contractual choice: the case of general practitioners in England," Health Economics Review, Springer, vol. 7(1), pages 1-14, December.
    3. Chevillard, Guillaume & Mousquès, Julien, 2021. "Medically underserved areas: are primary care teams efficient at attracting and retaining general practitioners?," Social Science & Medicine, Elsevier, vol. 287(C).
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    general practitioners; medically underserved area; integrated care; primary care teams; France;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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