[New technological equipments and their economical impact in ambulatory care]

The 1st Part of the study, based on 3 opinion surveys among ambulatory care providers (French physicians in private practice) shows a steady increase of prescribed technological "acts". However, the number of physicians having high-tech devices in their office is much lower. Ownership is understandably less frequent than equipment leasing or renting. In the French context, turnover of physicians for using high-tech equipment is outpaced by turnover of patients: as a rule, general practitioners send their patients to the specialist's offices or to hospitals (in France, the specialists practice both in ambulatory and institutional settings). The 2nd Part of the study, based on 4,471 physicians' tax files, attempts to identify the investment behavior of doctors in private practice regarding new technological devices. The specialty and the obsolescence speed of the equipment play both an important role. However, the choice between renting/leasing and purchasing depends also whether the doctor has a long run or a short term perspective. Such a choice is clearly evidenced through the French mechanisms of income taxation. It explains why the doctor's annual income (gross or net) is not significantly related to his investment behavior.