Carine Milcent

Carine Milcent

Membre associé

Research Professor CNRS

Campus Jourdan – 48 Boulevard Jourdan 75014 Paris

Bâtiment A, 2e étage, bureau 203

Tél. 01 43 13 63 44

  • Santé
  • Structure de marché et politique de concurrence
  • Comportements individuels
  • Protection sociale

Hospital inefficiency, disparities, and DRG-based payment

Controlling hospital expenditures and improving healthcare quality seem irreconcilable. Depending on healthcare regulation, the incentive can be on cost reduction at the expense of quality or the other way around. Therefore, finding the right balance between the two is a most important issue in many developed or developing countries. A DRG-based payment, often associated to a competition mechanism, is the most popular and widely used reimbursement payment over the world. In a context of a private healthcare sector, it raises some issues as patient's selection, innovation adoptions, up-coding, ... this has been widely studied in the US context. But, what can we say in the context of a public healthcare sector? I focus on the French DRG-based payment and its consequences: improvement in efficiency, level of quality, suppliers’ behaviour including up-coding, cost regulation.

Healthcare Reforms in China and Digital Healthcare

In this field of study, I present a global picture of the healthcare organization including the medication market in China, how public healthcare insurance plans have been implemented over the last years and I study the inefficiency of the Chinese healthcare system and the series of current reforms to deal with. I also expose the increase in the violence in the relationship between patient's relatives and the medical staff, and how the digital healthcare is used as a tool to solve the inefficiency from the public sector and a tool to generate profit by the private sector. Besides, I also focus on healthcare access and urbanization in China, migration and healthcare in China. 

Insurance System and Healthcare

The goal of this research axis is to determine to what extent the presence of health insurance create price distortion on i) the market of drugs, ii) patient's healthcare-seeking behaviour. This question is all the more interesting that the share of drugs in overall health expenditures is steadily growing. The players of the drug industry being global, this issue does not have borders. It is studied in different countries, mainly in France and China. The focus is also on the healthcare demand itself. To assess this demand, I use both objective measurements (body mass index, mortality rate….) and subjective index (assessment of their own health situation by patients).