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dc.contributor.authorDumontet, Magali*
hal.structure.identifierInserm U1219, Population Health Research Center
dc.contributor.authorBuchmueller, Thomas*
hal.structure.identifierInstitut de Recherche et Documentation en Economie de la Santé [IRDES]
dc.contributor.authorDourgnon, Paul*
hal.structure.identifierLaboratoire d'Economie de Dauphine [LEDa]
dc.contributor.authorJusot, Florence*
hal.structure.identifierInserm (UMR 1219)
dc.contributor.authorWittwer, Jérôme*
dc.date.accessioned2020-01-06T16:31:51Z
dc.date.available2020-01-06T16:31:51Z
dc.date.issued2017
dc.identifier.issn0168-8510
dc.identifier.urihttps://basepub.dauphine.fr/handle/123456789/20387
dc.language.isoenen
dc.subjectGatekeepingen
dc.subjectPhysician services utilizationen
dc.subjectReform evaluationen
dc.subject.ddc334en
dc.subject.classificationjelI.I1.I18en
dc.titleGatekeeping and the Utilization of Physician Services in France: Evidence on the Médecin Traitant Reformen
dc.typeArticle accepté pour publication ou publié
dc.description.abstractenIn 2005, France implemented a gatekeeping reform designed to improve care coordination and to reduce utilization of specialists’ services. Under this policy, patients designate a médecin traitant, typically a general practitioner, who will be their first point of contact during an episode of care and who will provide referrals to specialists. A key element of the policy is that patients who self-refer to a specialist face higher cost sharing than if they received a referral from their médecin traitant. We consider the effect of this policy on the utilization of physician services. Our analysis of administrative claims data spanning the years 2000–2008 indicates that visits to specialists, which were increasing in the years prior to the implementation of the reform, fell after the policy was in place. Additional evidence from the administrative claims as well as survey data suggest that this decline arose from a reduction in self-referrals, which is consistent with the objectives of the policy. Visits fell significantly both for specialties targeted by the policy and specialties for which self-referrals are still allowed for certain treatments. This apparent spillover effect may suggest that, at least initially, patients did not understand the subtleties of the policy.en
dc.relation.isversionofjnlnameHealth Policy
dc.relation.isversionofjnlvol121en
dc.relation.isversionofjnlissue6en
dc.relation.isversionofjnldate2017
dc.relation.isversionofjnlpages675-682en
dc.relation.isversionofdoi10.1016/j.healthpol.2017.04.006en
dc.contributor.countryeditoruniversityotherFRANCE
dc.contributor.countryeditoruniversityotherUNITED STATES
dc.relation.isversionofjnlpublisherElsevieren
dc.subject.ddclabelEconomie socialeen
dc.relation.forthcomingnonen
dc.relation.forthcomingprintnonen
dc.description.ssrncandidatenonen
dc.description.halcandidateouien
dc.description.readershiprechercheen
dc.description.audienceInternationalen
dc.relation.Isversionofjnlpeerreviewedouien
dc.relation.Isversionofjnlpeerreviewedouien
dc.date.updated2019-11-22T17:59:07Z
hal.identifierhal-02429628*
hal.version1*
hal.update.actionupdateMetadata*
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