The Dartmouth Atlas is well known for examining regional variation in practice patterns in the U.S. It looks like researchers in France are taking a similar approach to evaluate their own single payer system. A paper by Mercier, Georgescu and Bousquet (2015) find:
We assessed disparities in potentially avoidable hospitalizations in France in 2012 and analyzed their determinants. The standardized rate of potentially avoidable hospitalizations ranged from 0.1 to 44.4 cases per 1,000 inhabitants, at the ZIP code level. Increased potentially avoidable hospitalizations were associated with higher mortality, lower density of acute care beds and ambulatory care nurses, lower median income, and lower education levels. This study unveils considerable variation in the rate of potentially avoidable hospitalizations in spite of France’s mandatory, publicly funded health insurance system.
The authors find that primary care organizations play a role in the rate of avoidable hospitalizations in a given geographic region.
- Gregoire Mercier, Vera Georgescu, and Jean Bousquet. Geographic Variation In Potentially Avoidable Hospitalizations In France. HEALTH AFFAIRS 34, NO. 5 (2015): 836–843