Hospitalization for Ambulatory-care sensitive conditions (ACSC) in Ile de France: A view from across the Atlantic

Among wealthy nations belonging to the Organization for Economic Cooperation and Development (OECD), as of 2013, the United States continues to stand out as the one with the lowest rate of health care coverage for its population. 1 In this respect, it remains an exception, and in many quarters this characteristic has earned the United States a reputation for backwardness in the realm of social policy. The paradox stemming from this condition is that due to the magnitude of problems faced by the uninsured and underinsured, the United States has become a leader in the measurement and analysis of these conditions. In this sense, Thorstein Veblen’s insight about the « advantages of backwardness, » albeit in the radically different context of Imperial Germany’s economic development, seems germane. Few would dispute the evidence in support of the proposition that France provides its resident population with better access to health care than the United States (Gusmano et. al. 2013). In the spirit of Veblen, current buzz words in French health policy, e.g. les parcours de soins, les parcours de santé, les maisons médicales, les maisons pluridisciplinaires, le chronic care model, along with the development of prevention quality indicators, are, for the most part, exported from the United States. Likewise, recent attention, in France, with measuring access to the kinds of primary care services known to affect hospital discharges for so-called