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Centre for Health Economics and Policy Analysis


Seminar to examine impact of France reforms on access to care

04 Dec 2008

The impact of recent health care reforms in France aimed at regulating access to specialist care will be discussed at the CHEPA Monthly Seminar on Dec. 10.

Paul Dourgnon, a senior research fellow at the Institute for Research and Information In Health Economics in Paris, France, will deliver a talk entitled Did the 2004/06 French Gate keeping reform lead patients to reduce their use of specialist care for economic reasons? An assessment of the reform using self assessed unmet need.

He will discuss the findings of a research project that evaluated what effect the reforms had on the utilization of specialist care.

The core element of the reforms was establishment of a system of a “gate keeper” or “preferred” doctor for patients, who would determine whether the patients needed to see a specialist. The system was designed to introduce managed care in the ambulatory care sector, which previously was based on free access and fee-for-service payment. The reforms aimed to regulate access to specialist care, and lessen unnecessary or redundant visits to create greater efficiency in the provision of health care.

Patients could still access specialist care directly, but paid more to do so.

Dourgnon examined whether the new system created a barrier in access to care. His research shows the reforms created additional cost-sharing for patients, and affected the ability of the less affluent to access specialist care. He also discusses the use of self assessed unmet need to evaluate the impact of a reform on access to care.

Dourgnon, who is spending a semester as a visiting researcher at CHEPA, has a master’s degree from Ecole National de la Statistiques et de l’analyse de l’information in France. His research interests include equity in health and health care utilization, public health policy evaluations and survey methodology.

The seminar will be held in HSC-4N55A from 12:30 to 1:30 p.m. Everyone is welcome to attend.

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