Medical Spending in France: Concentration, Persistence and Evolution before Death

Christelle Gastaldi-Ménager, Pierre Geoffard and Grégoire de Lagasnerie ()
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Grégoire de Lagasnerie: OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development, PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement

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Abstract: This paper studies medical spending in France from three perspectives: concentration, persistence, and evolution before death. We use claims data from a representative sample of over 500,000 individuals covered by the National Health insurance scheme, from 2008 to 2013. These data contain individual-level information (gender, age, date of death), some clinical information and detailed information on each medical treatment (inpatient, outpatient, drugs). Medical spending in France is highly concentrated. In 2013, 10 per cent of the population accounted for 62 per cent of all health care spending. In addition, the concentration of medical expenditure increased between 2008 and 2013. The concentration of insurance reimbursement, however, is even greater, indicating that French social health insurance redistributes income from the healthy to the unhealthy. The serial correlation of health care expenditures appears relatively high between adjacent years, but not surprisingly decreases over time. Decedents have high medical expenditures – on average, eight times those of survivors – and resources devoted to health care in the last three years of life represent, on average, 22 per cent of lifetime medical spending. Decedents' expenditures decrease with age after 55 years old.

Keywords: Medical spending; France (search for similar items in EconPapers)
Date: 2016-09
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Citations: View citations in EconPapers (2)

Published in Fiscal Studies, 2016, 37 (3-4), pp.499-526. ⟨10.1111/j.1475-5890.2016.12107⟩

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Related works:
Journal Article: Medical Spending in France: Concentration, Persistence and Evolution before Death (2016)
Working Paper: Medical Spending in France: Concentration, Persistence and Evolution before Death (2016)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:pseptp:halshs-01509725

DOI: 10.1111/j.1475-5890.2016.12107

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