Sophie Thiébaut’s research while affiliated with French Institute of Health and Medical Research and other places

The healthy ageing assumptions may lead to substantial changes in paths of aggregate health care expenditure, notably catastrophic expenditure of people at the end of the life. But clear assessments of involved amounts are not available when we specifically consider ambulatory care (as drug expenditure) generally offered to chronically-ill people. We estimate the effects of epidemiological and life expectancy changes on French health expenditure until 2029 by applying a Markovian micro-simulation model from a nationally representative database. The originality of these simulations holds in using an aggregate indicator of morbidity–mortality, capturing vital risk and making it possible to adapt the quantification of life expectancies by taking into account the presence of severe chronic pathologies. We forecast future national drugs expenditure, under different epidemiological scenarios of chronic morbidity: trend scenario, healthy ageing scenario and medical progress scenario. For the population aged 25+, results predict an increase in reimbursable drug expenditure of between 1.1% and 1.8% (annual growth rate), attributable solely to the ageing population and changes in health status.

A microeconomic analysis of the impact of estate recovery for long-term care This paper examines the possible reform of the system of aid to dependent individuals ( Apa ), a reform aimed at recovering the subsidies awarded from the individual’s bequest. We develop a theoretical model with a dependent parent and an offspring that can potentially act as informal carer. The parent decides how much formal aid to buy, while the offspring decides how much informal care to provide to her parent. The model is solved for three cases: no altruism, altruism from bequests (towards a surviving spouse or offspring), and altruism towards the parent. We show that recovering the subsidy from the bequest increases the amount of informal aid supplied by a non-altruist offspring, while the versions with altruism yield ambiguous results. Classification JEL : D11, D3

This paper examines the possible reform of the system of aid to dependent individuals (ARA), a reform aimed at recovering the subsidies awarded from the individual's bequest. We develop a theoretical model with a dependent parent and an offspring that can potentially act as informal carer. The parent decides how much formal aid to buy, while the offspring decides how much informal care to provide to her parent. The model is solved for three cases: no altruism, altruism from bequests (towards a surviving spouse or offspring), and altruism towards the parent. We show that recovering the subsidy from the bequest increases the amount of informal aid supplied by a non-altruist offspring, while the versions with altruism yield ambiguous results. © Presses de Sciences Po. Tous droits réservés pour tous pays.

We propose a method for predicting the evolution of ambulatory health expenditure (i.e. non-hospital) under the effect of aging of the French population by 2025. The model includes two indicators of health status through which each agent of the database pass through microsimulation (thus creating an epidemiological dynamic at the individual level). Using an econometric model of consumption of healthcare services, we deduce the French health spending in 2025 by aggregating the representative aged population in 2025. The support chosen for the first application of the tool is the Health and Social Protection Survey (ESPS2000) of IRDES paired with the Public Insured Permanent Sample (EPAS). The topic is the impact of epidemiological changes on the amount of outpatient expenditures. These simulations were conducted for three epidemiological scenarios: a scenario of constant epidemiologic dynamic, a healthy aging scenario and a healthy aging + medical progress scenario (without taking into account the price effects).

Assessing the impact of epidemiological changes on health care expenditures in France for 2025: a micro-simulation approach We propose a method for predicting the evolution of ambulatory health expenditure (i.e. non-hospital) under the effect of aging of the French population by 2025. The model includes two indicators of health status through which each agent of the database pass through microsimulation (thus creating an epidemiological dynamic at the individual level). Using an econometric model of consumption of healthcare services, we deduce the French health spending in 2025 by aggregating the representative aged population in 2025. The support chosen for the first application of the tool is the Health and Social Protection Survey (ESPS2000) of IRDES paired with the Public Insured Permanent Sample (EPAS). The topic is the impact of epidemiological changes on the amount of outpatient expenditures. These simulations were conducted for three epidemiological scenarios: a scenario of constant epidemiologic dynamic, a healthy aging scenario and a healthy aging + medical progress scenario (without taking into account the price effects).

The healthy ageing assumptions may lead to substantial changes in paths of aggregate health care expenditure, notably catastrophic expenditure of people at the end of the life. But clear assessments of involved amounts are not available when we specifically consider ambulatory care (as drug expenditure) generally offered to chronically-ill people. We estimate the effects of epidemiological and life expectancy changes on French health expenditure until 2029 by applying a Markovian micro-simulation model from a nationally representative database. The originality of these simulations holds in using an aggregate indicator of morbidity–mortality, capturing vital risk and making it possible to adapt the quantification of life expectancies by taking into account the presence of severe chronic pathologies. We forecast future national drugs expenditure, under different epidemiological scenarios of chronic morbidity: trend scenario, healthy ageing scenario and medical progress scenario. For the population aged 25+, results predict an increase in reimbursable drug expenditure of between 1.1% and 1.8% (annual growth rate), attributable solely to the ageing population and changes in health status

Nous proposons une méthode de microsimulation, mise au point par l’Inserm SE4S à partir de la littérature médicoéconomique, de l’évolution des dépenses de médicaments remboursables (en médecine de ville) sous l’effet du vieillissement et de l’évolution de l’état de santé de la population française à l’horizon 2029. À partir de l’appariement de l’Enquête sur la santé et la protection sociale (ESPS) 2004 de l’Irdes et l’Échantillon permanent d’assurés sociaux (EPAS), nous construisons 3 scenarii épidémiologiques. Nous obtenons ainsi pour les 25 ans et plus des taux de croissance annuels de dépenses en médicaments, imputables uniquement au vieillissement de la population et aux évolutions de l’état de santé, situés entre 1,14% et 1,77 %. �.