The author systematically examines one of the important issues of information — establishing the market price. He introduces the concept of «search» — where a buyer wanting to get a better price, is forced to question sellers. The article deals with various aspects of finding the necessary information.

Economics of Information

Professor Titmuss, an eminent English social theorist, believes that man is inherently altruistic and that the duty of government is to create that social and economic climate which best channels man's drive to work together for the common good. In support of this belief, he has written a book about the procurement, distribution, and transfusion of human blood, a medical topic which he employs as an illustrative social and economic microcosm. The conclusion he reaches is foregone: "The voluntary socialized system in Britain is economically, professionally, administratively and qualitatively more efficient than the mixed, commercialized, and individualistic American system" (Titmuss, R.M: "Why Give to Strangers?" Lancet 1 :123-125, 1971). As the book was written with a bias, so will it be read with bias. My own bias is that of an American and a blood-banker. I am only too conscious of many deficiencies in the American complex of arrangements—it isn't

The Gift Relationship: From Human Blood to Social Policy

https://halshs.archives-ouvertes.fr/halshs-01133749/document

Mapping innovation dynamics in hospitals

Background
Diagnosis of breast cancer at early stages is associated with better clinical and survival outcomes. How the costs of care vary depending on the stage at which breast cancer was diagnosed has not been thoroughly examined.

Comparison of Treatment Costs for Breast Cancer, by Tumor Stage and Type of Service

In a growing number of countries, health technology assessment (HTA) has come to be seen as a vital component in policy making. Even though the assessment of the social, political, and ethical aspects of health technology is listed as one of its main objectives, in practice, the integration of such dimensions into HTA remains limited. Recent social scientific research on the inherently political nature of technology strongly supports such a comprehensive approach. The growing claims by and on behalf of consumer groups also suggest that HTA should be informed by a broader set of perspectives. Using the example of the cochlear implant in children, this essay compares the professed objectives of HTA with typical practice and explores possible explanations for the discrepancies observed. A second example, home telemonitoring for elderly persons, demonstrates how the types of evidence considered by HTA and the process through which assessments are produced may be reconsidered. We argue for the formal integration of the sociopolitical dimensions of health care technologies into assessments. The ability of HTA to more fully address important issues from a public policy point of view will increase by making explicit the sociopolitical nature of health care technologies.

Technology Assessment and the Sociopolitics of Health Technologies

Background
With the increasing burden of chronic diseases, analyzing and understanding trajectories of care is essential for efficient planning and fair allocation of resources. We propose an approach based on mining claim data to support the exploration of trajectories of care.

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A data mining approach for grouping and analyzing trajectories of care using claim data: the example of breast cancer

Cet article propose une lecture comparee de deux evolutions paralleles majeures de la politique de sante : l’autonomisation du patient et la regulation par la demande. Une premiere tendance de fond est de prendre en consideration le patient comme acteur autonome. Dans les faits, l’emergence d’un patient actif s’est traduite par la structuration d’un droit des patients privilegiant le droit a l’information et la recherche du consentement eclaire. Simultanement la politique economique met l’accent sur la demande dans la regulation de la depense de sante. Cette double evolution conduit a l’emergence d’un consommateur de soins. Elle s’appuie sur la structuration d’un consommateur souverain car informe, evaluant des produits de sante standardises (panier de soins) et des services specifiques (medecin traitant). Cette analyse s’interroge sur les implications de ces transformations, en termes d’efficacite et d’equite.

Mutation du patient et construction d'un marché de la santé. L'expérience française

Through analysis of the French experience, this article explores the way economic policy has sought to encourage active, well-informed patients by giving them market power. The new status of the patient as consumer is based on two foundations: the endeavour to build a healthcare market and the activation of demand-based policies. The keystone of this new system is a conception of the market as a process constructed by economic policy. Recent measures such as the standardization of care and the introduction of incentives to respect a treatment pathway then constitute effective levers to establish a free-market rationale.

Market empowerment of the patient: the French experience.

La notion de reseau a connu rapidement un certain succes dans la litterature economique tant generaliste que specialisee en economie de la sante. Cependant la notion de reseau ne va pas de soi : les conceptions du reseau sont aussi diversifiees que leurs domaines d'application. ; Dans une premiere partie ce papier presente une conception evolutionniste et socio-economique de la notion de reseau structuree autour de la distinction suivante : le reseau peut etre concu comme une structure d'organisation des activites economiques (tels les reseaux d'infrastructure), ou comme une modalite de coordination, alternative au marche et a la hierarchie. ; Dans une seconde partie, ce papier propose d'analyser les mutations recentes du systeme de sante (relations de cooperation inter-hospitalieres, constitution de reseaux ville-hopital...) a partir de la notion de reseau et de ses proprietes presentees precedemment.

Concept de réseau et analyse des mutations récentes du système de santé

Background
In the context of implementing the National Stroke Plan in France, a spatial approach was used to measure inequalities in this disease. Using the national PMSI-MCO databases, we analyzed the in-hospital prevalence of stroke and established a map of in-hospital mortality rates with regard to the socio-demographic structure of the country.

/pdf/the-use-of-national-administrative-data-to-describe-the-o50myafcfa.pdf

Maryse Gadreau

Papers

A data mining approach for grouping and analyzing trajectories of care using claim data: the example of breast cancer

Mutation du patient et construction d'un marché de la santé. L'expérience française

Market empowerment of the patient: the French experience.

Concept de réseau et analyse des mutations récentes du système de santé

The use of national administrative data to describe the spatial distribution of in-hospital mortality following stroke in France, 2008-2011.