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Issues in health economics, benefiting from a high public visibility, are syntheses of latest IRDES research on health economics.
Questions d'économie de la santé published in 2010
Is there a Relationship between Volume of Activity and Quality of Care in French Hospitals? 
Questions d'économie de la santé n° 149. 2009/12.
Or Z., Renaud T.
Concentration of certain procedures in high-volume hospitals is increasingly being presented as a means of improving the quality of care. However, until now no study has verified the link between volume of activity and quality of the care in France. This study provides new quantitative evidence on the correlation between the volume and outcomes of care exploiting French hospital data. For six out of eight conditions studied, results show that the probability of readmission and mortality is higher in low-volume hospitals. The intensity and the functional form of the link differ by condition and depend on the technical complexity of the procedure/treatment. Moreover, the relation is not linear: the impact of volume on the outcomes flattens gradually as the activity increases. In certain domains, it may be efficient to limit the number of hospitals with very low volume but there would be little additional benefit to centralize hospital activity beyond a certain point.
Pathways to Retirement in Europe: Individual Determinants and the Role of Social Protection.
Questions d'économie de la santé n° 148. 2009/11.
Debrand T., Sirven N.
In Europe, the pathways to retirement are determined by individual factors such as age, gender, education level and health status, and contextual factors such as family and professional environments. In addition to these usual explanatory factors, this analysis equally focuses on the role of social protection systems. It demonstrates that European disparities in the employment rate of older workers, varying from 34% in Italy to 70% in Sweden, can largely be explained by the complementary and combined effects of the three facets of social protection: employment, pensions, disability.
Any public policy aiming to increase the workforce participation of older citizens in Europe should therefore take into account not only the complexity of individual determinants influencing the retirement decision, but also the interactive effect of all social protection categories and not simply those relating to pensions.
An Exploratory Evaluation of Multidisciplinary Primary Care Group Practices in Franche-Comté and Bourgogne
Questions d'économie de la santé n° 147. 2009/10.
Bourgueil Y., Clément M.-C., Couralet P.-E., Mousquès J., Pierre A.
The creation of maisons de santé pluridisciplinaires1 , grouping together first-contact medical and paramedical private practitioners providing a multidisciplinary healthcare service, is expanding throughout France. In view of the medical demographics crisis and geographical inequalities in the distribution of healthcare supply, this form of organisation is perceived as a means of ensuring a satisfactory, modern, good quality healthcare service throughout the country whilst improving health professionals’ working conditions.
An exploratory evaluation of nine MSPs conducted in the French regions Franche-Comté and Bourgogne confirms that these structures, compared with traditional general medical practice, allows for a better balance between private life and professional practice. The MSPs present further advantages: greater accessibility due to longer opening hours, efficient cooperation between professionals –notably between general practitioners and nurses–, and a more extensive care supply.
Follow-up care for type 2 diabetes patients equally seems of better quality in MSPs despite the heterogeneity of results. At this stage, it is impossible to clearly ascertain whether office-based medical care expenditures have increased or decreased among MSPs patients. |
QUESTIONS D'ECONOMIE DE LA SANTE
