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Les « déserts médicaux » comme leviers de la réorganisation des soins primaires, une comparaison entre la France et l’Allemagne

Abstract : In view of the proportions that the challenge of territorial inequalities in primary care has taken on, this article explores two questions: What explains the prominence of this issue? And what is the relationship between it and the reorganization of primary care? To answer these questions, the authors draw a comparison between France and Germany, in which they identify the key actors in the according health political processes. This affords insight into the ways in which the reorganization of primary care is put onto the political agenda. In both countries a reversal is witnessed in the discourse around medical demographics found in the early 2000s, along with emphasis on the issue of a shortage of doctors in certain territories – a subject increasingly addressed by health policies. The diverse instruments mobilized to guarantee a supply of healthcare in disadvantaged territories are fairly similar: mainly zoning, general practitioner training, and financial incentives. However, the analysis of interactions between actors reveals more significant transformations in France, with the establishment of new local actors (ARS and territorial governments) contributing to the territorialisation of primary care, and with the development of multi-professional work in the context of new modes of organizing primary care driven by “medical entrepreneurs”.
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Submitted on : Monday, June 29, 2020 - 1:09:40 PM
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Patrick Hassenteufel, François-Xavier Schweyer, Thomas Gerlinger, Renate Reiter. Les « déserts médicaux » comme leviers de la réorganisation des soins primaires, une comparaison entre la France et l’Allemagne. Revue française des affaires sociales, La documentation française, 2020, 1 (1), pp.33-56. ⟨10.3917/rfas.201.0033⟩. ⟨hal-02883736⟩



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