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Comportements et pratiques des médecins : exercer dans les zones les moins dotées, cela fait-il une différence ?

Abstract : According to recent projections, the number of private practice physicians will decrease by 30 % by 2027 and the standardised density will continue to decline up to 2023, thus creating territorial inequalities in physicians’ distribution in mainland France. This article focuses on the adaptations that private general practitioners (GPs) make when they already practice in underserved areas. The data used are those of the third panel of general practitioners matched with indicators provided by the Social Security (CNAMTS). We used the local potential accessibility indicator developed by IRDES and DREES to define the underserved areas for general practitioners. Our results show that GPs’ consultation rhythm is higher in underserved areas, while the overall working-time is not very responsive to the local medical density. We also find some statistically significant differences in practices : more frequent prescription of certain drugs, less referrals to paramedical care, probably less regular gynaecological follow-up, for GPs practicing in underserved areas compared to their counterparts in better-served areas. However, it appears that there are no significant differences regarding the indicators of Rémuneration sur objectifs de santé publique (ROSP) [French supplementary payment-for-performance] program, which could allow a first assessment of the quality of care.
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Submitted on : Monday, February 17, 2020 - 7:11:10 PM
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Julien Silhol, Bruno Ventelou, Anna Zaytseva, Claire Marbot. Comportements et pratiques des médecins : exercer dans les zones les moins dotées, cela fait-il une différence ?. Revue française des affaires sociales, La documentation française, 2019, 1 (2), pp.213-249. ⟨10.3917/rfas.192.0213⟩. ⟨hal-02475133⟩

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