Search results for "community care services"
showing 6 items of 6 documents
The foundations of the new theories in health economics
1997
In health economics, theoretic approaches such as the theory of contracts, the economy of conventions, the theory of transaction costs and the evolutionary theory, have been applied recently. The present paper offers a classification of these different theories focusing on their epistemological foundations. The clarification of their assumptions about individual rationality (substantial or procedural rationality), about coordination modality (by inter-individual contracts or collective rules), about uncertainty (probabilistic risk or cognitive uncertainty), shows oppositions between these theories. Nevertheless, the application of these different theories in health economics shows that they…
Pour une nouvelle planification hospitalière (une estimation des besoins hospitaliers en Bourgogne)
1998
Alors que l'approche institutionnelle de la planification sanitaire cible l'évolution du besoin en soins hospitaliers, c'est à dire en inputs, l'approchepopulationnelle part du besoin de santé global de la population, dont la satisfaction constitue l'output du processus de soins. La modélisation présentée dans cet article procède d'une telle logique populationnelle. Elle cherche à estimer le nombre de lits hospitaliers nécessaires et suffisants pour couvrir l'ensemble des besoins de la population d'une zone donnée, à partir des caractéristiques démographiques et des modes de recours à l'hospitalisation.La détermination des besoins par zone est susceptible d'entraîner une nouvelle allocation…
Modeling of medical activity heterogenity to improve the hospital management by diagnosis-related groups
1998
Since the early 1980s healthcare systems in the industrialized nations have been undergoing radical reform aimed at curbing overspending of hospital expenditure. After a discussion of the limits of a prospective payment due to heterogeneity of costs within DRGs, we demonstrate the ability of anovel statistical model to identify high cost patients. We derive from this statistical model an economic heuristic in order to account for high cost patients in budget allocation and a Structural and Contingent method is proposed as a budgeting tool. Economic analysis based on this modeling of DRG heterogeneity further reveals the potential for improving the equity and the efficiency of the prospectiv…
Strategical behaviours in French ambulatory care (a theoretical and empirical study)
1991
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
1996
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…
From free health care to pricing in subsaharian Africa : rise and fall of the project "health for all"
1997
The idea o f the "health for all", that consists in insure to each the free access to health care and the equality on treating, has been found enough rapidly taken in defect by the catastrophic economic situation of countries of Africa to the South o f the Sahara. Faced with the impossibility to promote a free health policy for all, local governments and international organisations, such the WHO and the UNICEF, have proposed to make pay users for cares that they receive and to decentralize management of public health system so as to create the favorable environment to a market of health. This reform of health system in Subsaharan Africa, called the Bamako Initiative, is going to tempt to so…