Nous proposons une méthode de prédiction de l’évolution des dépenses de santé ambulatoires (i.e. non hospitalières) sous l’effet du vieillissement de la population française à l’horizon 2025. Le modèle intègre deux indicateurs d’états de santé sur lesquels chaque agent de la base de données pourra transiter, par microsimulation, créant ainsi une dynamique épidémiologique individuelle entre bonne et mauvaise santé. À l’aide d’un modèle économétrique de consommation de biens et services de santé, nous déduisons la dépense française en santé en 2025 par agrégation de la population représentative vieillie en 2025. Le support choisi pour la première application de l’outil est la base de données ESPS 2000 de l’IRDES appariée avec l’Échantillon permanent d’assurés sociaux (EPAS). Le thème traité est l’impact de changements épidémiologiques sur le montant des dépenses ambulatoires. Ces simulations ont été réalisées pour trois scénarios épidémiologiques : scénario à dynamique épidémiologique constante, vieillissement en bonne santé et vieillissement en bonne santé + progrès médical (sans prise en compte des effets prix).

Socioeconomic-related inequalities in healthcare delivery have been extensively studied in developed countries, using standard linear models of decomposition. This paper seeks to assess equity in healthcare delivery in the particular context of the occupied Palestinian territory: the West Bank and the Gaza Strip, using a new method of decomposition based on microsimulations. Besides avoiding the 'unavoidable price' of linearity restriction that is imposed by the standard methods of decomposition, the microsimulation-based decomposition enables to circumvent the potentially contentious role of heterogeneity in behaviours and to better disentangle the various sources driving inequality in healthcare utilisation. Results suggest that the worse-off do have a disproportinately greater need for all levels of care. However with the exception of primary-level, utilisation of all levels of care appears to be significantly higher for the better-off. The microsimulation method has made it possible to identify the contributions of factors driving such pro-rich patterns. While much of the inequality in utilisation appears to be caused by the prevailing socioeconomic inequalities, detailed analysis attributes a non-trivial part (circa 30% of inequalities) to heterogeneity in healthcare-seeking behaviours across socioeconomic groups of the population. Several policy recommendations for improving equity in healthcare delivery in the occupied Palestinian territory are proposed.

OBJECTIVE: Scaling up antiretroviral treatment (ART) through decentralization of HIV care is increasingly recommended as a strategy toward ensuring equitable access to treatment. However, there have been hitherto few attempts to empirically examine the performance of this policy, and particularly its role in protecting against the risk of catastrophic health expenditures (CHE). This article therefore seeks to assess whether HIV care decentralization has a protective effect against the risk of CHE associated with HIV infection. DATA SOURCE AND STUDY DESIGN: We use primary data from the cross-sectional EVAL-ANRS

Objectives To assess the risk of leaving employment for cancer survivors 2 years after diagnosis and the role of workplace discrimination in this risk.Methods A representative sample of 4270 French individuals older than 17 and younger than 58 years when diagnosed with cancer in 2002 were interviewed 2 years later. Their occupational status was analyzed with the help of Probit and IV-Probit models.Results Overall, 66% of the cancer survivors who were working at the time of diagnosis were still employed 2 years later. Age, education level, income at diagnosis, work contract, professional status, affective support, relative prognosis at diagnosis, tumor site and treatment have contrasting impacts upon the probability of job loss across gender. Even after having controlled for these variables, self-reported workplace discrimination increases the probability of job loss by 15%.Conclusions Despite protective labor law and favorable health insurance arrangements, French cancer survivors continue to experience problems to stay in or to return to the labor force. Measures targeting only the employment protection of cancer survivors do not seem to be sufficient to end prior social inequalities in job attainment. Intervention for specific populations particularly exposed to job-loss risks would also be needed.