{"id":2244,"date":"2021-03-02T09:17:02","date_gmt":"2021-03-02T08:17:02","guid":{"rendered":"http:\/\/observatoire-asap.org\/?p=2244"},"modified":"2021-07-01T23:13:25","modified_gmt":"2021-07-01T21:13:25","slug":"les-impacts-socio-economiques-du-dispositif-public-des-ateliers-sante-ville","status":"publish","type":"post","link":"https:\/\/observatoire-asap.org\/index.php\/2021\/03\/02\/les-impacts-socio-economiques-du-dispositif-public-des-ateliers-sante-ville\/","title":{"rendered":"Les impacts socio-\u00e9conomiques du dispositif public des Ateliers Sant\u00e9 Ville"},"content":{"rendered":"<p style=\"text-align: justify;\">En 2000, le <a href=\"https:\/\/www.cohesion-territoires.gouv.fr\/\">Comit\u00e9 interminist\u00e9riel des villes<\/a> a encourag\u00e9 des exp\u00e9rimentations en mati\u00e8re de sant\u00e9 sur les territoires prioritaires de la politique de la ville et a introduit le dispositif des Ateliers Sant\u00e9 Ville (ASV), pilot\u00e9 par des agents communaux. Ces commissions de travail, organis\u00e9es \u00e0 l\u2019\u00e9chelle des Quartiers Prioritaires de la Ville (QPV), ont pour objectif de r\u00e9duire les in\u00e9galit\u00e9s sociales et territoriales dans l\u2019acc\u00e8s aux droits de sant\u00e9, \u00e0 la pr\u00e9vention et aux soins. Sont r\u00e9unis associations, habitants, \u00e9tablissements sanitaires, professionnels de sant\u00e9 lib\u00e9raux, institutions et collectivit\u00e9s territoriales du territoire.<\/p>\n<p style=\"text-align: justify;\">Si les ASV sont per\u00e7us comme un levier de la d\u00e9mocratie sanitaire locale, certains \u00e9lus doutent de leur efficacit\u00e9. Malgr\u00e9 les donn\u00e9es existantes (Motard, Tessier 2016), les Mairies peinent \u00e0 d\u00e9montrer les impacts socio-\u00e9conomiques de ce dispositif. Comment \u00e9valuer ces impacts&nbsp;? Une recherche-intervention, conduite par l\u2019ISEOR en 2018-2019, utilisant la <a href=\"http:\/\/observatoire-asap.org\/index.php\/2021\/02\/10\/comment-evaluer-les-impacts-socio-economiques-dun-dispositif-public\/\">m\u00e9thodologie de l\u2019\u00e9valuation socio-\u00e9conomique<\/a> (Savall, Goter, 2021), a permis d\u2019identifier et de mesurer les performances cach\u00e9es des ASV. 2 quartiers ont \u00e9t\u00e9 choisis pour une approche contrast\u00e9e. 62 personnes, dont 33 \u00e0 deux reprises, ont \u00e9t\u00e9 interview\u00e9es pour recueillir les impacts sociaux et \u00e9conomiques (Savall, Goter, Bondin, 2019).<\/p>\n<p style=\"text-align: justify;\">Sur le plan social, les ASV assurent une meilleure interconnaissance des partenaires. La connaissance des missions et r\u00f4les respectifs permet de d\u00e9velopper davantage de coop\u00e9ration et de synergies dans le cadre d\u2019actions telles que, par exemple, le d\u00e9pistage du cancer du sein. Les r\u00e9unions de travail favorisent la remont\u00e9e d\u2019informations de terrain. Les groupes de travail favorisent la d\u00e9couverte de solutions communes. Une mont\u00e9e en comp\u00e9tences des partenaires est constat\u00e9e, tant sur l\u2019ing\u00e9nierie de projet que dans le domaine de la sant\u00e9. En identifiant les besoins des usagers par des partenaires sur le terrain, l\u2019ASV propose des actions strat\u00e9giques plus pertinentes et efficaces du point de vue de la sant\u00e9 publique.<\/p>\n<p style=\"text-align: justify;\">Sur le plan \u00e9conomique, la mutualisation des comp\u00e9tences et des ressources mat\u00e9rielles permet de r\u00e9aliser des actions qui n\u2019auraient pu voir le jour sans le travail en r\u00e9seau. Elle permet de r\u00e9aliser des \u00e9conomies et autofinance le travail en r\u00e9seau. D\u2019autre part, les partenaires ASV gagnent du temps dans la mobilisation de leur r\u00e9seau, dans les projets et l\u2019accompagnement des usagers. Deux types d\u2019impacts \u00e9conomiques ont \u00e9t\u00e9 identifi\u00e9s. Ils constituent des performances cach\u00e9es d\u2019un dispositif public, car ils ne sont habituellement pas mesur\u00e9s&nbsp;:<\/p>\n<ul>\n<li>des co\u00fbts \u00e9vit\u00e9s : Les ASV \u00e9vitent des d\u00e9penses de sant\u00e9 et r\u00e9duisent les temps pass\u00e9s par l\u2019ensemble des acteurs agissant sur le parcours de sant\u00e9 des usagers.<\/li>\n<li>des captations de ressources : Les ASV mobilisent des ressources mat\u00e9rielles, financi\u00e8res et de temps pass\u00e9s par tous les acteurs consacr\u00e9s \u00e0 am\u00e9liorer la sant\u00e9 des usagers.<\/li>\n<\/ul>\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong><u>Captation de ressources<\/u><\/strong><br>Gains de subventions d&rsquo;actions de promotion et de pr\u00e9vention de la sant\u00e9<br>Co-construction d&rsquo;activit\u00e9s de sant\u00e9 publique avec les habitants<br>Mont\u00e9e en comp\u00e9tences des structures associatives et des professionnels<br><strong><u>Co\u00fbts \u00e9vit\u00e9s<\/u><\/strong><br>Mutualisation de moyens sur les \u00e9v\u00e9nements<br>Meilleurs orientation et acc\u00e8s aux droits et aux soins<br>Am\u00e9lioration de l&rsquo;hygi\u00e8ne de vie des usagers<br>Moindre augmentation du nombre de b\u00e9n\u00e9ficiaires de l&rsquo;Affection Longue Dur\u00e9e (ALD)<br>Acc\u00e8s rapide \u00e0 l&rsquo;information pour les partenaires et informations crois\u00e9es<br>Doublons d&rsquo;actions de sant\u00e9 \u00e9vit\u00e9s<br>Gains de temps sur la r\u00e9alisation d&rsquo;un diagnostic et sur la mise en place d&rsquo;un projet<\/td><\/tr><\/tbody><\/table><figcaption>Synth\u00e8se de la nomenclature des co\u00fbts \u00e9vit\u00e9s et des captations de ressources<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Exemple de calcul co-produit avec des partenaires ASV&nbsp;: le groupe de travail ASV organise des activit\u00e9s physiques visant \u00e0 r\u00e9duire l\u2019isolement des femmes moins co\u00fbteuses que les activit\u00e9s physiques de droit commun. 50 habitantes du quartier participent aux ateliers&nbsp;:&nbsp; 50 habitantes x 10&nbsp;% x 3493 \u20ac (d\u00e9pense moyenne par personne li\u00e9e \u00e0 une maladie cardio-vasculaire), soit plus de 17 100 \u20ac de d\u00e9penses de sant\u00e9s \u00e9vit\u00e9s.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n<p style=\"text-align: justify;\">Dans le quartier A, la performance \u00e9conomique d\u00e9gag\u00e9e est de 925&nbsp;600 \u20ac par an, gr\u00e2ce \u00e0 l\u2019affectation et \u00e0 la mobilisation de 8 personnes (ETP&nbsp;: partenaires, coordinatrices, chef de la mission sant\u00e9). Dans le quartier B, elle est de 747&nbsp;700 \u20ac (8,75 personnes ETP).<\/p>\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td class=\"has-text-align-left\" data-align=\"left\"><\/td><td>Performances cach\u00e9es totales<\/td><td>Co\u00fbts \u00e9vit\u00e9s<\/td><td>Captations de ressources<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Quartier A<\/td><td>925&nbsp;600 \u20ac<\/td><td>498&nbsp;200 \u20ac<\/td><td>427 400 \u20ac<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Quartier B<\/td><td>747 900 \u20ac<\/td><td>687 000 \u20ac<\/td><td>60 700 \u20ac<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n<p style=\"text-align: justify;\">En conclusion, les ASV g\u00e9n\u00e8rent des performances cach\u00e9es\u00a0: celles dont on ne parlait pas et que l\u2019on n\u2019avait pas mesur\u00e9es. Ainsi la Ville a les moyens de p\u00e9renniser le dispositif ASV qui d\u00e9gage une performance socio-\u00e9conomique pour le territoire, sup\u00e9rieure \u00e0 ce qu\u2019il co\u00fbte (budgets allou\u00e9s, temps pass\u00e9 par les agents de la Ville). Ces r\u00e9sultats montrent que le dispositif ASV, int\u00e9ressant du point de vue de la sant\u00e9 publique, est \u00e9conomiquement viable (Savall, Cappelletti, Raphan, 2020).<\/p>\n<p style=\"text-align: right;\"><a href=\"http:\/\/observatoire-asap.org\/index.php\/2021\/02\/05\/francoise-goter\/\">Fran\u00e7oise Goter <\/a>et<a href=\"http:\/\/observatoire-asap.org\/index.php\/2021\/02\/05\/veronique-zardet\/\"> V\u00e9ronique Zardet<\/a><\/p>\n<p><strong>R\u00e9f\u00e9rences<br \/><\/strong><span style=\"font-size: inherit;\">Savall H., Goter F., Bondin L. (2019), <\/span><em style=\"font-size: inherit;\">\u00c9valuation socio-\u00e9conomique des Ateliers Sant\u00e9 Ville<\/em><span style=\"font-size: inherit;\">, Rapport ISEOR, 333 p.<br \/><\/span>Savall H., Goter F. (2021), \u00ab Comment \u00e9valuer les impacts socio-\u00e9conomiques d\u2019un dispositif public ? \u00bb, Article publi\u00e9 dans l\u2019<em>Observatoire ASAP<\/em>.<br \/>Motard C. &amp; Tessier S. (2016). \u00ab\u00a0Les d\u00e9marches Ateliers sant\u00e9 ville : la promotion de la sant\u00e9 \u00e0 l\u2019\u0153uvre dans les territoires\u00a0\u00bb, <em>Sant\u00e9 Publique<\/em>, 6(6), 729-733.<br \/>Savall H., Cappelletti L., Raphan P. A. (2020), poster le CNAM et ISEOR, \u00ab\u00a0La m\u00e9thode des co\u00fbts-performances cach\u00e9s : outil strat\u00e9gique et op\u00e9rationnel d\u2019\u00e9valuation des politiques publiques\u00a0\u00bb, Les rencontres de l\u2019\u00e9valuation, <em>Assembl\u00e9e Nationale<\/em>, 13 f\u00e9vrier 2020.<br \/>Savall H. et Zardet V. (1987). <em>Ma\u00eetriser les co\u00fbts et les performances cach\u00e9s, Le contrat d\u2019activit\u00e9 p\u00e9riodiquement n\u00e9gociable<\/em>, prix Harvard l\u2019Expansion de management 6<sup>e<\/sup> strat\u00e9gique, Economica, \u00e9dition en 2015. (Traduit en anglais : Mastering Hidden Costs, IAP, Charlotte : NC, 2008).<\/p>","protected":false},"excerpt":{"rendered":"<p>En 2000, le Comit\u00e9 interminist\u00e9riel des villes a encourag\u00e9 des exp\u00e9rimentations en mati\u00e8re de sant\u00e9 sur les territoires prioritaires de la politique de la ville et a introduit le dispositif des Ateliers Sant\u00e9 Ville (ASV), pilot\u00e9 par des agents communaux. Ces commissions de travail, organis\u00e9es \u00e0 l\u2019\u00e9chelle des Quartiers Prioritaires de la Ville (QPV), ont &hellip; <\/p>\n","protected":false},"author":1,"featured_media":2248,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"spay_email":"","footnotes":""},"categories":[10],"tags":[85],"class_list":["post-2244","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","tag-lettre6"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Les impacts socio-\u00e9conomiques du dispositif public des Ateliers Sant\u00e9 Ville -<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/observatoire-asap.org\/index.php\/2021\/03\/02\/les-impacts-socio-economiques-du-dispositif-public-des-ateliers-sante-ville\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Les impacts socio-\u00e9conomiques du dispositif public des Ateliers Sant\u00e9 Ville -\" \/>\n<meta property=\"og:description\" content=\"En 2000, le Comit\u00e9 interminist\u00e9riel des villes a encourag\u00e9 des exp\u00e9rimentations en mati\u00e8re de sant\u00e9 sur les territoires prioritaires de la politique de la ville et a introduit le dispositif des Ateliers Sant\u00e9 Ville (ASV), pilot\u00e9 par des agents communaux. 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