Evidence map›Paper›PMID 32748104›Full record

ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2020

How French general practitioners respond to declining medical density: a study on prescription practices, with an insight into opioids use.

Julien Silhol, Bruno Ventelou, Anna Zaytseva

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In one paragraph

Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Prescription opioids and economic hardship in France.The European journal of health economics : HEPAC : health economics in prevention and care · 2023
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Julien SilholInstitut National de la Statistique et des Etudes Economiques (Insee), Montrouge, France.
Bruno VentelouAix-Marseille University, CNRS, EHESS, Centrale Marseille, AMSE, Marseille, France. bruno.Ventelou@univ-amu.fr.ORCID http://orcid.org/0000-0003-0774-1525
Anna ZaytsevaAix-Marseille University, CNRS, EHESS, Centrale Marseille, AMSE, Marseille, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Disparities in physicians' geographical distribution lead to highly unequal access to healthcare, which may impact quality of care in both high and low-income countries. This paper uses a 2013-2014 nationally representative survey of French general practitioners (GPs) matched with corresponding administrative data to analyze the effects of practicing in an area with weaker medical density. To avoid the endogeneity issue on physicians' choice of the location, we enriched our variable of interest, practicing in a relatively underserved area, with considering changes in medical density between 2007 and 2013, thus isolating GPs who only recently experienced a density decline (identifying assumption). We find that GPs practicing in underserved areas do shorter consultations and tend to substitute time-consuming procedures with alternatives requiring fewer human resources, especially for pain management. Results are robust to considering only GPs newly exposed to low medical density. Findings suggest a significant impact of supply-side shortages on the mix of healthcare services used to treat patients, and point to a plausible increased use of painkillers, opioids in particular.

Indexed as

Analgesics, OpioidGeneral PractitionersPractice Patterns, Physicians'FranceHealth ServicesHumansPopulation DensityPovertyAnalgesics, OpioidFranceGeneral practitionersHealth workforceMedically underserved areaOpioidsPrescriptions

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.