Dynamics and Transformation of Healthcare Consumption in France – DynamicHealth

Healthcare needs in France are expected to grow in the next few decades. Aging population, an increase in diseases due to sedentary and poor health behavior (France is one of the European countries with the highest alcohol and tobacco consumption), a shortage of doctors, and the growth of treatment costs associated with innovation are expected to put pressure on the rise of healthcare expenditure. These major issues require a better understanding of how and why healthcare expenditure (HCE) evolves to better anticipate future healthcare needs. Evidence from foreign countries is hardly transposable to the French case, and little is known about the factors of HCE growth in France. Moreover, how these growth factors vary across time is still unknown. The factors driving HCE growth most of the time let aside the role of supply and demand. Thus, little is known, for example, about the impact of doctor shortage on HCE; whether telemedicine addresses medical desert issues; or how public policies can affect HCE.
DynamicsHealth aims to take advantage of the French administrative data that covers exhaustively every health care use for all French residents, to develop a pioneer and comprehensive analysis of how HCE evolves in France and to explain the reasons for these changes on the supply and demand sides. The main objectives are to: (i) describe the evolution of care over 16 years and understand the role of aging, technology, morbidity, and economic factors; (ii) identify the causal impact of supply variation on HCE. I will focus on the closure of doctors' practices and the arrival of new types of supply, such as telemedicine. (iii) Understand how public policies can modify the demand for healthcare by other levers than price. The role of having access to care through or under an insured (child under his parent and spouse under his wife) will be of particular interest because it highlights the role of confidentiality rules on healthcare demand.