La Rémunération sur Objectifs de Santé Publique : ça marche ? Bilan de la ROSP de 2012 à 2016 à partir des données de la Sécurité Sociale concernant les médecins généralistes de Martinique

Abstract : Introduction: Remuneration on Public Health Objectives is a Performance Payment System introduced in 2012 primarily for general practitioners. The study aims to: carry out the assessment of the ROSP from 2012 to 2016 in Martinique and establish a comparison with the national level; identify the clinical translation of an evolution of practices. Is the evolution of practices the specific effect of ROSP? Material and methods: From the Social Security data bases several analyzes were carried out with different methodologies. The analysis of the ROSP level required the use an exclusion criterion. The main analysis is a retrospective cohort study of the exposed / unexposed type. The main criterion of judgment is the evolution of the evolution of the level of the ROSP. Results: The evolution in Martinique is globally similar to that observed at the national level. The improvement in ROSP does not result into an unequivocal improvement in the management of patients for the monitoring of chronic diseases and prevention. The ROSP seems to behave like a fee of € 6.5 per patient. ROSP has an incentive effect independent of confounding factors. The evolution of physicians strongly influenced by the ROSP is greater than that of weakly influenced physicians. Conclusions: The evolution of practices is partly related to the ROSP. The level of achievement of objectives in Martinique is lower than at national level. The ROSP has not fully achieved its goals for the management of chronic patients and the improvement of prevention.
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Master Thesis
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Olivier Soussain. La Rémunération sur Objectifs de Santé Publique : ça marche ? Bilan de la ROSP de 2012 à 2016 à partir des données de la Sécurité Sociale concernant les médecins généralistes de Martinique. Médecine humaine et pathologie. 2018. ⟨dumas-01962708⟩

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