[Seminaire CREM] New professional roles in primary care and health care consumption: the example of midwives skills in France

New professional roles in primary care and health care consumption: the example of midwives skills in France, co-écrit avec Henri Panjo (INSERM) et Carine Franc (INSERM)

Many OECD countries implement reforms redesigning roles of healthcare professionals to improve the efficiency of health care sector. In 2009, a reform in France expanded midwives’ scope of practice to include gynecological care of non-pregnant women, alongside their traditional roles in pregnancy and childbirth. This paper explores the effect of this reform on healthcare utilization of women and how this effect varies according to women’s characteristics. Using administrative data on healthcare utilization in French women, we investigate the change in the probability of consulting a midwife between 2007 and 2017 among non-pregnant women aged 15 to 55. Our results show an increase of midwives utilization after the reform related to their new skills, particularly among recently pregnant women and those living in areas with poor access to healthcare services. Overall, the effect of reforms extending professional roles on healthcare utilization is highly dependent to information processes and it is likely to improve the efficiency of the primary care supply by increasing the supply in deprived areas.