Île-de-France has been facing a significant reduction in the number of private general practitioners for several years, as a result of an unfavorable age pyramid with many retirements, a low number of new doctors and overall an attractiveness deemed less by young doctors in the region for this medical specialty.
To combat this phenomenon and improve access to care, the Agency determines, at least every three years, the geographical areas characterized by an insufficient medical supply or by difficulties in accessing care. Due to the pandemic, the 2018 card has been exceptionally extended by one year.
The decree of March 30, 2022 signed by Amélie Verdier, Director General of ARS Île-de-France, determines these areas (living-health territories) in which doctors will be supported by financial or material aid for the installation and maintaining. The revision of physician zoning contributes to strengthening equal access to care in the territories. The ARS has therefore established, after consulting the CRSA and the URPS Médecins Libéraux and extensive consultation with its partners, a new map of the territories presenting difficulties in accessing medical care.
Increasing difficulties in accessing primary care in Île-de-France, but targeted aid that proves its effectiveness
Since the previous doctors' zoning of 2018, the situation in Ile-de-France has continued to deteriorate, with however a slowdown in the reduction of general practitioners: -1.9% (around 155 general practitioners) between 2018 and 2020 throughout the Ile-de-France territory , while in the previous period, the decrease exceeded 150 general practitioners per year between 2016 and 2018, i.e. three times more. Since 2018, the “priority intervention zones (ZIP)” have represented more than 4.4 million inhabitants (i.e. 37% of the Ile-de-France population). For these areas, a lower loss (0.2%) of general practitioners was observed. The various aids provided between 2018 and 2020 have thus made it possible to maintain general practitioners in the Ile-de-France territories identified in ZIPs.
In addition, the ARS Île-de-France noted that the decrease in general practitioners was mainly in areas that had not been identified as ZIPs in 2018, where aid was therefore less or even absent. A finding that was taken into account in the realization of the 2022 doctors zoning in order to identify these territories which have not benefited from major evolution on the installation of new general practitioners.
A methodology adapted to the Ile-de-France region
The national methodology is mainly based on the "Localized Potential Accessibility (APL)" indicator which is calculated each year by the DREES, taking into account in particular the activity per practitioner (number of consultations or visits carried out during the year), the access time to the practitioner and consumption of care by age group.
For the first time, the use of the APL indicator by the ARS was optional to establish their regional zoning.ARS Île-de-France has therefore chosen to adapt the national methodology, to fully take into account the specificities of the region, with the creation of a score based on 7 criteria: two based on the characteristics of the population of each territory, which are not taken into account in the national score, with the social characteristics (Human Development Indicator2017,a human development assessment tool in Île-de-France that brings together three dimensions: health, education, income), morbidity (proportion of long-term illnesses – ALD); 5 which cover, in detail, the situation of doctors, with the density of general practitioners by territory, the evolution of the workforce, the dynamics of installation, the age of general practitioners and the density of specialist doctors.
Today, the proportion of the Ile-de-France population eligible forZIP (Priority Intervention Zones, beneficiaries of Health Insurance and State aid) thus goes from 37.6% in 2018 to 62.4%,or 7.6 million inhabitants. The proportion of the Ile-de-France population eligible forZAC (Zones d’Actions Complementaires, beneficiaries of State aid only) represents 33.9%i.e. 4.1 million inhabitants (39.5% in 2018). For the other territories (3.7%), no individual aid is provided.
These new results reflect the very worrying difficulties of access to primary care in the Ile-de-France territories and show a sharp deterioration in a few years. In total, more than 96.3% of the Ile-de-France population lives in an area that is insufficiently endowed with general practitioners, i.e. 3.7% (450,000 inhabitants) who would benefit from access to a satisfactory general practitioner. The ARS welcomes the support that many local authorities also provide to encourage these installations and is strengthening coordination to maximize the leverage effect of aid.
A new doctors’ zoning with the unprecedented creation of a “priority intervention zone +”
Although all the Ile-de-France territories classified as ZIPs are affected by the difficulty of access to a general practitioner, in particular due to numerous retirements, for certain areas, particularly rural or disadvantaged areas, this difficulty is further increased by the total absence new facilities.
This is why the ARS Île-de-France has chosen to distinguish, within the zones classified as ZIP, zones called ZIP+, in order to support them even more by additional financial incentives and also by support for their exercise in these most tense areas.
Individual and collective aid to help set up and maintain doctors
The measures to improve the situation of medical demography mainly aim to encourage doctors and especially young people to settle in the region through different types of aid. But also to keep them active longer or to improve their working conditions.
Various aids aimed at encouraging settlement in ZIP territories have already been put in place in the context of previous zoning by the ARS and by the Health Insurance. In total, since 2018, nearly 1,200 conventional contracts have been signed in Ile de France, including 479 installation assistance contracts (CAIM). In addition, funding from the ARS and the Health Insurance aimed at promoting the creation and operation of Multidisciplinary Health Centers, or even Professional Territorial Health Communities (CPTS), have been deployed (146 open MSPs and 44 CPTS Operating).
With this new zoning, many individual aids of a financial nature are maintained, either within the conventional framework by Health Insurance, including the CAIM installation assistance contract of €50,000, or by the ARS, during the installation of the doctor in a territory with a deficit (Start-of-practice contract). They can also take the form of contracts financing the studies of students or interns (CESP), in return for settling in these territories. They are supplemented by support for doctors carried out in partnership between the ARS and the URPS Médecins to promote liberal practice or the search for a place of practice adapted to the wishes of the professional.
In addition, significant aid is devoted to the investment and operation of MSPs, health centers or group practices that attract and retain young doctors, in collaboration with the URPS Médecins.
Finally, with the creation of 103 ZIP+ covering more than 3.8 million inhabitants in Ile de France, more than a quarter of the Ile-de-France territories will receive more aid, with in particular an additional envelope of €10,000 which will be granted to general practitioners who settle there. Aid for the secretariat, for maintaining retirees in activity and for internship supervisors welcoming interns will also be implemented. Finally, additional support will be provided for the creation of Multidisciplinary Health Centers, Health Centers or Territorial Professional Health Communities in these territories.
Find the doctors' zoning maps by department:
FAQs
What is an example of zoning? ›
Zoning allows local governments to regulate which areas under their jurisdiction may have real estate or land used for particular purposes. Examples of zoning classifications include residential, commercial, agricultural, industrial, or hotel/hospitality, among other more specific designations.
What are local zoning codes? ›Zoning codes are a set of rules that regulate what can and can't be done on a particular piece of property. They're established and enforced at the city level.
What is a type of zoning in which density is determined for an entire area rather than on a lot by lot basis? ›Determining density for an entire area rather than on a lot-by-lot basis is typically called cluster zoning. This type of zoning is often used to create a mix of housing types and uses in an area while preserving green space.
How can zoning laws be beneficial to cities residents? ›How can zoning laws be beneficial to a city's residents? Zoning laws can protect and enhance the value of real estate, and prevent the incompatibility of different land uses. Most importantly, zoning laws can help accomplish overall goals of a given community and stimulate economic growth.
What is zoning diagram in architecture? ›What Is Zoning in Architecture? Zoning is essentially a set of codes that outline the rules for what may be built on a particular property. Zoning codes limit the size, shape, use, and location of buildings. Architects perform zoning analyses in order to determine the legal development rights of a property.
What does LAC4 zoning mean? ›The Property's LAC4 zoning allows for limitless use & development potential. Page 1. Conceptual Design. The Property's LAC4 zoning allows for limitless use & development potential.
What is the purpose of zoning at the local level? ›Zoning is how the local government regulates and develops land within its control. It is broken down into multiple categories to help balance a city to ensure proper land use and provide value to citizens that own property.
What is LCA22 zoning? ›The LCA22 zoning allows a house and you may look into development for gorgeous views for custom homes. KEY FEATURES: Property Type: Agriculture, Recreational, Residential, Ranching, Development.
What is zoning method? ›Zoning is a widespread technique for hand-written character recognition. When a zoning method is considered, the pattern image is subdivided into zones each one providing regional information related to a specific part of the pattern.
What does RE11 zoning mean? ›There are 5 RE zones, RE9, RE11, RE15, RE20, and RE40, with the number corresponding to the minimum lot size in thousands of square feet. For example, RE11 requires 11,000 SF minimum lots. All of the single-family zones in LA require a minimum of 2 covered parking spaces.
What are the disadvantages of zoning? ›
Zoning requires that all involved property owners relinquish some of their individual property freedoms for the common good. Zoning can discourage some development in some locations. Zoning can increase the cost of building new structures. Zoning can work against historic mixed use neighborhoods in older communities.
What are the benefits of rezoning? ›This lessens the financial burden landmarking can have on property owners, which reduces opposition to historic property regulation and provides funds for the maintenance of these buildings. Within a major business district, rezoning can also help improve both pedestrian and vehicular circulation on street networks.
What is an example of exclusionary zoning? ›Common examples include minimum lot size requirements, minimum square footage requirements, prohibitions on multi-family homes, and limits on the height of buildings. The origins of such laws date back to the nineteenth century, as many cities were concerned about fire hazards as well as light-and-air regulations.
What is one negative of zoning regulations related to urban planning? ›Zoning that is too restrictive often makes it difficult for developers to build necessary projects such as multi-family housing. But when zoning is too loose, it creates neighborhoods that aren't walkable and don't have a strong sense of community.
What are the 5 US zones? ›A common way of referring to regions in the United States is grouping them into 5 regions according to their geographic position on the continent: the Northeast, Southwest, West, Southeast, and Midwest.
What are the 4 different zones? ›Anthropologist Edward Hall coined this word in the early 1960s and classified 4 major proxemic zones: the intimate space, personal space, social space, and public space.
What are the three basic zones? ›The Earth has three main climate zones: tropical, temperate, and polar.
What are the four zones used when planning and designing a residential space? ›Typically, homes have four zones: social zones; work zones (kitchen, utility, office); private zones (bedrooms, bathrooms); and storage zones (cupboards, closets and cabinets).
What is the difference between bubble diagram and zoning? ›Answer and Explanation:
Bubble diagrams are often used for landscape projects at the first stage of the design as a quick idea or representation and after approval of the design for future detail when the work starts. Zoning drawings, on the other hand, may also be used for landscape projects but it is more specific.
Demarcate the zone
Chalk out a list of smaller functional spaces to be created within the larger space and then allot the estimated square foot space to each area. Many interior designers are using this tactic to create a diverse atmosphere in one single space. Fashion stores and restaurants are also following suit.
What does Zone 2 mean in real estate? ›
RW1: One-family residential zone. RW2: Two-family residential waterway zone. R2: Two-family dwelling / or two one-family dwellings on one parcel or lot. RD2: Restricted density.
What are the three most common zoning designations? ›- R for residential buildings.
- C for commercial.
- I for industrial.
ZONING is LCA12. LC means Los Angeles County, The "2" means 2 acre mimimun lot size.
What is an important function of zoning laws? ›The basic purpose and function of zoning is to divide a municipality into residential, commercial, and industrial districts (or zones), that are for the most part separate from one another, with the use of property within each district being reasonably uniform.
What is the practice of zoning and why is it important to city planning? ›Zoning—the process of planning for land use across geographic areas—can help avoid the mixing of incompatible land uses. This has both environmental and economic benefits. Zoning practices vary widely around the world.
What are zoning laws and local ordinances? ›A zoning ordinance is a rule that defines how property in specific geographic zones can be used. Zoning ordinances detail whether specific geographic zones are acceptable for residential or commercial purposes.
What does SF 10 zoning mean? ›The SF-10 Single Family Residential District - 10,000 is intended to provide for development of primarily detached, single family residences on lots of not less than ten thousand (10,000) square feet.
What is zoning code SF 10? ›The Single-Family Residential 10 (SF-10) District is established to accommodate principally single-family detached residential development at low densities, and to accommodate flexibly-designed residential development that provides variable housing types and arrangements that respond to environmental and site ...
What is zoning SF? ›Zoning regulations govern how land can be used in areas of San Francisco called "zoning districts" (also known as "zones" or "use districts").
How do I find local zoning laws? ›Call your municipal planning or building department.
The planning department typically executes the zoning laws for a particular location. Even if you think you understand how the laws work in your area, it's always best to call and get an official opinion regarding the specific property before you rely on it.
What is another word for zoning? ›
synonyms for zoning
On this page you'll find 9 synonyms, antonyms, and words related to zoning, such as: banding, bordering, bounding, circumscribing, delimiting, and girdling.
Zoning is a standard method of measuring retail premises to calculate and compare their value. It is used by both public and private sector surveyors. Zoning as a method has been applied in the UK to the analysis of shop rents and properties for rating purposes since the 1950s.
What is R3 zone in CA? ›R3 (Residential, Multi-Family Medium-Density) District. The R3 zoning district provides for the development of a wide range of multi-family dwelling units, including apartments and condominiums.
What does floor area ratio 3 1 mean? ›FAR is expressed as a ratio. An FAR of 3:1 means that for every square foot of Buildable Area, an owner may build up to three square feet of Floor Area.
What does RD1 5 mean? ›RD1. 5 – One unit per 1,500 sq ft of land. RD2 – One unit per 2,000 sq ft. R3 – This is where things get interesting.
Why are zoning laws justified in dealing with negative externalities? ›For example, the zoning laws prevent the building of a polluting factory near a residential area. People can suffer from diseases and other harmful effects due to the noise, air, or water pollution created by the use of such buildings. Hence, these are justified as they deal with negative externalities.
What is advantage of density zoning? ›Density Zoning Helps Manage Growth
Density zoning allows cities and counties to restrict and manage growth and development in accordance with their objectives. Local governments may establish minimum or maximum density requirements for future development projects.
Zoning creates this Economy of Externality by reducing suboptimal spatial adjacencies that experience suggests generate negative effects. Recall that externalities require not just a polluter but also a pollutee.
What is the most common type of zoning in the United States? ›The most common type of zoning in California and throughout the United States is residential zoning, which restricts certain areas to homes and some small businesses.
What does zoning mean at Walmart? ›In the retail industry, facing (also known as blocking, zoning or levelling) is the practice of pulling products forward to the front of the display or shelf on which they are placed, typically with the items' labels facing forward.
What is zoning in the US? ›
Zoning is the process of dividing a municipality into separate districts, or zones, upon which differing regulations, typically regarding land use, are applied. The enforcement of these regulations is enabled by the police powers delegated from the state to local government.
What are the benefits of zoning? ›Zoning regulation is an important planning tool that benefits communities economically and socially, improves health and wellness, and helps conserve the environment. Local zoning regulation allows communities to plan for the use of land transparently, involving residents through public meetings.
What type of zoning is used to promote the highest and best use of the land? ›A property owner may appeal for a variance which exempts the owner from a particular zoning ordinance. Directive zoning is used to promote the highest and best use of the land.)
What is the purpose of zoning quizlet? ›Zoning, in its simplest form, is the separation of land uses. Many communities use zoning to control land uses. Zoning is implemented through locally enacted legislation that regulates and controls the use of private property.
What are Walmart employees called? ›Position Summary...
Our merchandising & stocking associates connect all of the dots to make sure members can find everything they have on their shopping list. From every day needs to special occasions, members need you, as their mini tour guide, to take them that special product.
Due to the inconclusive results, Hicks (2008) mentions that demographic factors relating to income, population density, and distance from key wholesalers may be the decision making factor(s) that prompt Wal-Mart to build a particular type of store in a given location.
What does zoning someone mean? ›verb (used with object),friend-zoned, friend-zon·ing. Slang. to put (someone) in the friend zone: He wonders why he's always getting friend-zoned by women he likes.
What is known as a zone? ›: any of five great divisions of the earth's surface with respect to latitude and temperature compare frigid zone, temperate zone, torrid zone. : a portion of the surface of a sphere included between two parallel planes. archaic : girdle, belt. 3. : an encircling anatomical structure.
What do you call different areas of land? ›A region is an area of land that has common features. A region can be defined by natural or artificial features.
What are the pros and cons of zoning? ›- Zoning requires that all involved property owners relinquish some of their individual property freedoms for the common good.
- Zoning can discourage some development in some locations.
Who is considered the father of zoning? ›
Edward Murray Bassett (February 7, 1863 – October 27, 1948), "the father of American zoning", and one of the founding fathers of modern-day urban planning, wrote the first comprehensive zoning ordinance in the United States, which was adopted by New York City in 1916.
What cities in the US have no zoning laws? ›Houston is the only major city in the U.S. without zoning ordinances. It has never had zoning ordinances. You might assume that the situation would be pretty horrible there as a result. You'd expect to find a high rise in a small neighborhood of single family homes, towering over them and blotting out the sun.