| Titre : | France: health system review 2023 |
| Auteurs : | European observatory on Health Systems and Policies (Copenhagen, DNK) ; Zeynep Or ; Coralie Gandré ; Anna-Veera Seppänen ; et al. |
| Type de document : | Ouvrage |
| Editeur : | Geneva [CHE] : World Health Organization - WHO, 2023/07 |
| Collection : | Health systems in transition , num. Vol. 25 n°3 |
| ISBN : | 978-92-890-5949-7 |
| Description : | 276p. / tabl., graph., fig., carte |
| Langues: | Anglais |
| Mots-clés : | Système santé ; Organisation ; Financement ; Réforme ; Santé publique [généralité] ; Démographie ; Etat santé ; Population ; Evaluation ; Management ; Ressource humaine ; Service santé ; France ; Rapport |
| Résumé : |
The Statutory Health Insurance system is universal and provides a generous benefits basket.
The French health system is structurally based on a social health insurance approach, but it also shares National Health System goals reflected in the single public payer model, the importance of tax-based revenue for financing healthcare, strong state intervention and residency-based benefits. The Statutory Health Insurance currently covers almost 100% of the resident population under various schemes, but cost-sharing is required for all essential services. Coverage is also available to undocumented migrants under certain conditions. The sustainability of the health workforce remains a challenge in underserved areas. While the number of most health workers has increased in the past decade, the number of general practitioners per capita in France has decreased, and this trend is expected to continue in the next years. Continued challenges in France include ensuring the sustainability of the health workforce, particularly to secure adequate numbers of health professionals in medically underserved areas, such as rural and less affluent communities, and improving working conditions, remuneration and career prospects, especially for nurses, to support retention. However, this is a slow process and progress has been incremental. Revenue-based financing has been broadened to improve the financial sustainability of the health system. The national government has been playing an increasingly important role in managing health expenditure since 2010 through the introduction of spending targets and monitoring mechanisms for health insurance, reducing the initial independence of the Statutory Health Insurance in managing health expenditure. To ensure financial sustainability, sources of health funding have been extended beyond payroll contributions in the past decades to include a broader range of sources of income, including financial assets and investments with a range of earmarked and value-added taxes. Reforms are targeting greater coordination and integration of care, and there is also a focus on improving equity and efficiency of the health system. As with many other health systems in Europe, the Covid-19 pandemic has brought to light some structural weaknesses within the French health system, but it has also provided opportunities for improving its sustainability. There has been a notable shift in the will to give more room to decision-making at the local level involving healthcare professionals and to find new ways of funding healthcare providers to encourage care coordination and integration. Future reforms target improving access to care and prevention as well as continuing the reform of primary care and provider payment to improve the equity in access and efficiency. Future challenges for the health system also include improving data availability for quality monitoring and regular evaluation of health system performance. |
| En ligne : | https://eurohealthobservatory.who.int/publications/i/france-health-system-review-2023 |
Documents numériques (1)
 France: health system review 2023 URL |