Background In 2009, a voluntary-based pay for performance scheme targeting general practitioners (GPs) was introduced in France through the ‘Contract for Improving Individual Practices’ (CAPI). Objective To study the impact of the CAPI on French GPs’ consultation length. Methods Univariate...

Background: In France, equality in access to screening has been one of the main thrusts of public policies implemented between 2009 and 2013 (the national cancer plan). Our aim in this study was to analyse the obstacles to and levers for breast, cervical, and colorectal cancer screening uptake...

Objective: Pay-for-performance programmes have been widely implemented in primary care, but few studies have investigated their potential adverse effects on the intrinsic motivation of general practitioners (GPs) even though intrinsic motivation may be a key determinant of quality in health...

Background Like many other OECD nations, France has implemented a pay-for-performance (P4P) model in primary care. However, the benefits have been debated, particularly regarding the possibly undesirable effects of extrinsic motivation (EM) on intrinsic motivation (IM). Objective To examine the...

In any fee for service system (FFS), doctors are incited to increase their activity such that outpatient care supply is strongly linked to private practice income. Thus, studying the private practice income determinants allows predicting doctors’ care provision. We aim first, to identify the...

In any fee-for-service system, doctors may be encouraged to increase the number of services (private activity) they provide to receive a higher income. Studying private activity determinants helps to predict doctors’ provision of care. In the context of strong feminization and heterogeneity in...

This thesis addresses several issues raised by the introduction in France of economic incentives such as pay-For-Performance applied to general practice. These incentive schemes are designed to improve the quality of care, but they are discussed both in terms of effectiveness and potential side...