0000000000948242
AUTHOR
Maryse Gadreau
Ethique professionnelle et régulation économique du marché des soins ambulatoires : de la théorie des contrats à l'économie des conventions
What is the part played by professionnal ethics in the economic regulation of the market for ambulatory care (heterogeneity, uncertainty, information asymmetry...) and extrinsic rigidities (imposed by medical corporation and public authorities) ? Is it the internal control variable from "interested" self-regulation that implicitly relies on teological conception of ethics ? Or, the essential being of conventions for "quality" and "activity" that, through the cycle of gift economics, set upspontaneous order, with respect to professional ethics ? What usecan we do with such theoritical approach for the understanding andthe trend of politics in ambulatory care ?
Strategical behaviours in French ambulatory care (a theoretical and empirical study)
Specifying agency relationships between the different actors in ambulatory care - the patient, the physician, the insurance and public authorities - allows to render an account of the complexity and the specificity of the health system. After a presentation of the normative approach of the agency theory, we will focus on two agency relationships : the Relationship between the insurance and insured people and the relationship between the patient and the physician. The driving part of supply appears through the analysis of the relationship between the physician and the others : he is the agent of both the patient and public authorities. The issue is then the hypothesis of supplier induced dem…
Networks and health care systems
The network concept has been successful in the economic littérature and in the health care economics littérature. However the network concept is not easy to define. In the first part, this paper suggests a framework for network conceptions analysis :first, network can be conceived as a structure of economic organisation (such as infrastructure networks), or as a coordination mode, alternative and different from market or hierarchy coordination. In the second part, this paper analyses recent mutations in the health care system (such as cooperation relationships between several hospitals and private clinics, networks between hospitals and ambulatory medical care...) from the network concept a…
Contribution à une nouvelle économie de la santé : asymétries d'information et régulation en médecine ambulatoire
Le fonctionnement de la médecine ambulatoire est analysé à travers la spécification de relations d'agence complexes qui s'instaurent entre les différents acteurs : le malade, le médecin, l'assurance, la tutelle. Après une approche conceptuelle et normative qui distingue relations d'agence "parfaites" et "imparfaites", l'accent est mis deux relations : la relation assurance-principal et assuré-agent sur le marché de l'assurance maladie, et la relation patient-principal et médecin-agent sur le marché des soins médicaux. Les "effets pervers" inhérents à l'asymétrie d'information sont étudiés en terme de sélection adverse et de risque moral. L'hypothèse d'une démarche induite par l'offre, consé…