108 research outputs found
National Authority for Health: France
Provides an overview of France's National Authority for Health, which defines best-care standards and assesses the benefit and effectiveness of new technologies for inclusion on benefits lists. Examines its use of comparative effectiveness research
Agent model with a monopoly power : physicians
The aim of this paper is to model a liberal profession, in this case physicians. We propose a model in which the physician acts in the same way as an agent who maximises his utility function subject to his budget constraint, while at the same time being able to affect his rate of remuneration. This model presupposes that physicians attempt to reach two target, namely income and leisure, and that the trade-o⏠between these two target depends on their monopolistic power. Unlike existing models, our proposed model advances that some physicians may have a disutility for leisure and may adopt altruistic or strategic behaviours. To determine the relevance of our model, we estimate salaried, firm and agent versions of the model based on a sample of 317 physicians practicing in the Provence-Alpes-CÎte d'Azur region (PACA). We observe that physicians do not act like a purely profit-maximising firm. Furthermore, they are able to affect their net remuneration rate through their labour supply. The model that we propose therefore is of particular importance. We estimate that around 20% of physicians experience disutility from leisure, which can be explained by their adoption of altruistic and strategic behaviours.Physicians, Income, Econometric Models
Provider Competition in a Dynamic Setting
In this paper, we examine provider and patient behaviour where effort is non-contractible and where competition between providers is modeled in an explicit way. More specifically, we construct a model where physicians repeatedly compete for patients and where patientsâ outside options are solved for in equilibrium. In our model, physicians are characterized by an individual-specific ethical constraint which allows for unobserved heterogeneity in the physicians market. By doing so, we introduce uncertainty in the patientâs likely treatment if he were in fact to leave his current physician to seek care elsewhere. We find that competition between providers may serve as an important incentive for physicians in treating their patients with desired levels of care.Physician Payment Mechanisms, Physician heterogeneity, Competition, Information Asymmetry, Insurance.
Optimal payment schemes for physicians
Increasingly, physiciansâ payment schemes are being reformed to en- hance performance and to ensure an optimal allocation of scarce medical resources. The empirical evidence points towards the use of mixed payment schemes that appear better at achieving efficiency than either lump sum payments (such as cap- itation) or piece rates (fee for service). Yet, this alleged superiority remains to be established from a theoretical standpoint. The Principal-Agent model developed in this paper offers a contribution in this line, with a primary care physician as agent and a public regulator as principal. Alternative specifications of the princi- palâs objective function are considered in the model (efficiency versus fairness). Uncertainty is introduced by two random variables that represent the probability for an individual of being ill and his productivity parameter which determines the amount of resources (the physicianâs effort in particular) necessary to restore health. The relationship is characterised by information asymmetry since the physician is assumed to observe both variables after the contract has been signed, but before choosing his effort level. Both selection and moral hazard issues are addressed in the model and the results show that, under GP risk neutrality, mixed payment schemes fully correct for both types of information asymmetry.info:eu-repo/semantics/publishedVersio
Agent model with a monopoly power : physicians
The aim of this paper is to model a liberal profession, in this case physicians. We propose a model in which the physician acts in the same way as an agent who maximises his utility function subject to his budget constraint, while at the same time being able to affect his rate of remuneration. This model presupposes that physicians attempt to reach two target, namely income and leisure, and that the trade-o between these two target depends on their monopolistic power. Unlike existing models, our proposed model advances that some physicians may have a disutility for leisure and may adopt altruistic or strategic behaviours. To determine the relevance of our model, we estimate salaried, firm and agent versions of the model based on a sample of 317 physicians practicing in the Provence-Alpes-CĂŽte d'Azur region (PACA). We observe that physicians do not act like a purely profit-maximising firm. Furthermore, they are able to affect their net remuneration rate through their labour supply. The model that we propose therefore is of particular importance. We estimate that around 20% of physicians experience disutility from leisure, which can be explained by their adoption of altruistic and strategic behaviours. [Authors]]]>
Physicians ; Income ; Models, Econometric
eng
https://serval.unil.ch/resource/serval:BIB_593001751D8A.P001/REF.pdf
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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_593001751D8A7
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https://serval.unil.ch/notice/serval:BIB_593006E8D85F
RĂ©actions Ă©motionnelles chez les patients en traitement palliatif
info:doi:10.4414/fms.2017.03138
info:eu-repo/semantics/altIdentifier/doi/10.4414/fms.2017.03138
Savioz, VĂ©ronique
Guex, Patrice
info:eu-repo/semantics/article
article
2017-12-06
Forum Medical Suisse, vol. 17, no. 49, pp. 1087-1093
info:eu-repo/semantics/altIdentifier/pissn/1661-6138
fre
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info:eu-repo/semantics/openAccess
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oai:serval.unil.ch:BIB_5930881AAFA5
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Analyse de la mobilité criminelle entre les cantons de GenÚve et Vaud (2009-2012)
Grossrieder, L.
Chopin, J.
Jendly, M.
Ecole des sciences criminelles (ESC)
info:eu-repo/semantics/report
techreport
2013
fre
oai:serval.unil.ch:BIB_5930D29F2172
2022-05-07T01:18:26Z
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Rate and mechanism of the photoreduction of birnessite (MnO2) nanosheets
info:doi:10.1073/pnas.1421018112
info:eu-repo/semantics/altIdentifier/doi/10.1073/pnas.1421018112
http://www.pnas.org/content/112/15/4600.short
Marafatto, Francesco Femi
Strader, Matthew L.
Gonzalez-Holguera, Julia
Schwartzberg, Adam
Gilbert, Benjamin
Peña, Jasquelin
info:eu-repo/semantics/article
article
2015-03
Proceedings of the National Academy of Sciences, vol. 112, no. 15, pp. 4600-4605
info:eu-repo/semantics/altIdentifier/pissn/0027-8424
info:eu-repo/semantics/altIdentifier/eissn/1091-6490
urn:issn:0006-2952
<![CDATA[The photoreductive dissolution of Mn(IV) oxide minerals in sunlit aquatic environments couples the Mn cycle to the oxidation of organic matter and fate of trace elements associated with Mn oxides, but the intrinsic rate and mechanism of mineral dissolution in the absence of organic electron donors is unknown. We investigated the photoreduction of ĂÂŽ-MnO2 nanosheets at pH 6.5 with Na or Ca as the interlayer cation under 400-nm light irradiation and quantified the yield and timescales of Mn(III) production. Our study of transient intermediate states using time-resolved optical and X-ray absorption spectroscopy showed key roles for chemically distinct Mn(III) species. The reaction pathway involves (i) formation of JahnĂąeuro"Teller distorted Mn(III) sites in the octahedral sheet within 0.6 ps of photoexcitation; (ii) Mn(III) migration into the interlayer within 600 ps; and (iii) increased nanosheet stacking. We propose that irreversible Mn reduction is coupled to hole-scavenging by surface water molecules or hydroxyl groups, with associated radical formation. This work demonstrates the importance of direct MnO2 photoreduction in environmental processes and provides a framework to test new hypotheses regarding the role of organic molecules and metal species in photochemical reactions with Mn oxide phases. The timescales for the production and evolution of Mn(III) species and a catalytic role for interlayer Ca2+ identified here from spectroscopic measurements can also guide the design of efficient Mn-based catalysts for water oxidation
Concurrence et antisĂ©lection en assurance maladie : lâexpĂ©rience des Pays-Bas
Quels sont les bĂ©nĂ©fices mais aussi les Ă©cueils attendus du renforcement de la concurrence sur le marchĂ© de lâassurance maladie ? Lâintervention de lâEtat demeure-t-elle justifiĂ©e ? Quelles sont les modalitĂ©s optimalesdâune telle intervention ? Autant dâinterrogations auxquelles le prĂ©sent article tente dâapporter des Ă©clairages Ă partir de la confrontation des rĂ©sultats de la thĂ©orie microĂ©conomique de lâassurance Ă lâexpĂ©rience pratique du systĂšme de santĂ© des Pays-Bas dans ce domaine.Which are the benefits but also the pitfalls to be expected from strengthening competition in the health insurance markets ? Is State intervention still legitimate ? Which are the optimal forms it should take ? These are some of the questions addressed in this paper whixh confronts the theorical predictions from insurance economics with the practical experience of the Dutch health care system
Concurrence et antisĂ©lection en assurance maladie : lâexpĂ©rience des Pays-Bas
Quels sont les bĂ©nĂ©fices mais aussi les Ă©cueils attendus du renforcement de la concurrence sur le marchĂ© de lâassurance maladie ? Lâintervention de lâEtat demeure-t-elle justifiĂ©e ? Quelles sont les modalitĂ©s optimalesdâune telle intervention ? Autant dâinterrogations auxquelles le prĂ©sent article tente dâapporter des Ă©clairages Ă partir de la confrontation des rĂ©sultats de la thĂ©orie microĂ©conomique de lâassurance Ă lâexpĂ©rience pratique du systĂšme de santĂ© des Pays-Bas dans ce domaine.Which are the benefits but also the pitfalls to be expected from strengthening competition in the health insurance markets ? Is State intervention still legitimate ? Which are the optimal forms it should take ? These are some of the questions addressed in this paper whixh confronts the theorical predictions from insurance economics with the practical experience of the Dutch health care system
Partage optimal entre assurance maladie privĂ©e et publique    : la situation française au regard dâexpĂ©riences Ă©trangĂšres
En France, lâassurance maladie complĂ©mentaire couvre dĂ©sormais plus de neuf personnes sur dix et a vocation Ă sâĂ©tendre encore. Cette gĂ©nĂ©ralisation progressive ainsi que les initiatives de gestion du risque prises par certains des opĂ©rateurs ont progressivement conduit Ă questionner sa place par rapport Ă celle de lâassurance obligatoire et, de maniĂšre plus gĂ©nĂ©rale, son rĂŽle dans le systĂšme de santĂ©. Cette question se pose dans la plupart des pays industrialisĂ©s, malgrĂ© des configurations, au dĂ©part trĂšs variables. Elle rejoint celle, plus gĂ©nĂ©rale, des rĂŽles respectifs du marchĂ© et de lâĂtat, qui, dans les secteurs tels que lâĂ©ducation ou la santĂ©, ont fait et continuent de faire lâobjet dâun dĂ©bat nourri.In France, private complementary health insurance covers nine out of ten individuals and the intention is to exend it further. This progressive generalisation coupled with the recent initiatives taken by private insurers to better manage health risks has led to a questioning of the relationship between such private schemes and the public compulsory health insurance fund, and more generally, of the role of such schemes in the health care system. This questioning is common to most industrialised countries although under variable forms. It comes to defining the respective roles of the State and the market which, in certain sectors such as education and health, still remains highly contentious
Origine sociale et Ă©tat de santĂ© des parents : Quelle influence sur lâĂ©tat de santĂ© Ă lâĂąge adulte ?.
Parmi les facteurs explicatifs proposĂ©s pour expliquer les inĂ©galitĂ©s sociales de santĂ©, la littĂ©rature Ă©pidĂ©miologique a rĂ©cemment mis en avant lâinfluence du milieu social dâorigine sur lâĂ©tat de santĂ© Ă lâĂąge adulte, cette influence rĂ©sultant Ă la fois dâun effet direct des conditions de vie dans lâenfance sur la santĂ© (latency model) et dâun effet indirect passant par lâinfluence du milieu dâorigine sur le statut socioĂ©conomique de lâenfant (pathway model). Par ailleurs, on peut supposer une influence directe de lâĂ©tat de santĂ© des parents sur celui des enfants, sâexpliquant non seulement par un patrimoine gĂ©nĂ©tique commun mais aussi par une transmission des comportements liĂ©s Ă la santĂ©. A partir dâune exploitation de lâenquĂȘte SHARE, cette recherche propose dâexplorer ces trois modĂšles, pour la premiĂšre fois en France, en Ă©tudiant le rĂŽle de la profession des deux parents et de leur Ă©tat de santĂ©, sur lâĂ©tat de santĂ© dâun individu Ă lâĂąge adulte, contrĂŽlĂ© par son statut socioĂ©conomique. Les rĂ©sultats montrent que lâĂ©tat de santĂ© Ă lâĂąge adulte, au-delĂ de son association avec la situation sociale actuelle de lâindividu, nâest pas indĂ©pendant de lâorigine sociale ni de lâĂ©tat de santĂ© des parents. La santĂ© Ă lâĂąge adulte semble ĂȘtre directement influencĂ©e par le statut socioĂ©conomique de la mĂšre et lâĂ©tat de santĂ© des deux parents, le statut socioĂ©conomique du pĂšre ayant au contraire une influence indirecte passant par la dĂ©termination du statut socioĂ©conomique de lâenfant. Ces rĂ©sultats suggĂšrent ainsi lâexistence en France dâune inĂ©galitĂ© des chances en matiĂšre de santĂ©.EgalitĂ©s des chances; inĂ©galitĂ©s de santĂ©; transmission intergĂ©nĂ©rationnelle; early life hypothesis;
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