Publications

Publications in Peer-reviewed Academic Journals


Abstract: The analysis of causes of death is crucial for monitoring the epidemiologic situation and developing adequate policy responses. Yet, various methodological challenges complicate such analysis. The comparability of cause-specific mortality data depends on the proportion of misclassified deaths. To eliminate the bias due to varying proportion of such causes over time and between populations, one has to reassign ill-defined causes to other categories. In this research note, we thoroughly document and provide tools for the practical implementation of a regression-based method for redistributing misclassified causes of death proposed by a French demographer, Sully Ledermann. The method relies on the sub-national cause-specific mortality data to estimate unbiased death rates at both the national and sub-national levels. We refine the Ledermann’s method through elaborating on its mathematical properties, making additional adjustments, and evaluating the performance of the approach through simulations. To illustrate the practical application of the method, we rely on the French regional data on causes of death for the period 1979–2016. To ensure the reproducibility of the obtained results and enable potential users to adapt the program to their data, we provide the R code performing all calculations. 

Population studies, 2024, https://doi.org/10.1080/00324728.2024.2332629 


Abstract:  This paper aims at projecting the disabled population aged 60 or more, and at identifying factors that impact those projections. In this aim, we develop a novel methodological approach. The novelty lies on the fact that this method allows to identify different parameters in the morbidity forecast (as for eg. a change in the probability to remain autonomous, a change in the distribution of survival gains across disability levels). In this model, health states and transitions from one state to another follow the epidemiological literature. This paper focuses on the methodological aspect of this new method, but also provides, as an illustration,  the projection of the French population in 2060, relying on the French CARE-M data and on the European data SHARE. It shows, among other results, that matching the past evolution of disability free life expectancy over total life expectancy requires optimistic assumptions regarding the evolution of the probability to remain autonomous.

Economie et statistique, 2023, https://doi.org/10.24187/ecostat.2023.538.2090


Abstract:  This paper examines the causal impact of later retirement on doctor visits among the French elderly. Previous studies mostly focus on the impact of the switch from employment to retirement on healthcare consumption, leaving aside the question of long-term impact of pension reforms on healthcare consumption among the retirees. This question is of interest since spillover effects may arise if savings from pension reforms is accompany by increases healthcare expenditure due to pension reforms. I exploit the 1993 French pension reform in a two-stage least square to deal with the endogeneity of retirement. This reform leads to a progressive increase in claiming age, cohort by cohort from 1934 to 1943. I use the administrative data HYGIE to observe both healthcare consumption between 2005 and 2015 and past careers. I find that an increase in retirement by four months decreases significantly the probability to have at least one doctor visit per year by 0.815 percentage point and decreases the number of doctor visits by 1.14% between ages 67 and 75. This effect is driven by the consumption of generalist doctor visits, and tends to be stronger for the first ages of consumption observed.

PSE Working paper n°2020-46

Annals of Economics and Statistics, 2022, https://doi.org/10.2307/48684788 


Abstract: This paper investigates the causal impact of formal care use on informal care among formal care users. We propose an original instrument for formal care use, using local disparities in the price of formal care providers. Using the French survey CARE, we implement a two-part model to show the effect of formal care on the extensive and on the intensive margin of informal care. An exogenous increase in formal care is found to slightly decrease the probability to use informal care. Heterogeneity tests show this negative effect is mainly driven by caregiving for daily life activities, provided by women and secondary caregivers. At the intensive margin, however, informal care is not significantly affected by a formal care increase. Reforms extending the generosity of public policies for formal care use can thus be expected to have a limited effect on informal care use, concentrated on specific caregivers.

PSE Working paper n°2019-60

European Journal of Health Economics, 2022,  https://doi.org/10.1007/s10198-021-01370-5


We investigate the causal effect of retirement on health through the literature. We explore the potential mechanisms which explain three effects: the switch from employment to retirement, later retirement and earlier retirement. The empirical strategies used to identify the causal effects are mainly based on the observation of changes in health status at the legal age for retirement entitlement or on reforms that have led to changes in retirement incentives. Literature renders the possibility of making several observations on the average effect estimation. Retirement leads to a decrease in healthcare consumption, better self-reported health, a decline in cognition, an ambiguous effect on physical health. Later retirement has no effect on mortality, decreases healthcare consumption and cognitive abilities, has non-significant impact on self-reported health. Studies on the impact of earlier retirement are scarce due to few natural experiments exploiting such a variation. The latter studies show a decrease in mortality, no effect on healthcare consumption and worse self-reported health and cognition. Lastly, some studies find evidence of heterogeneous effects by gender, marital status and occupational status. As there are relatively few studies on this aspect, the question should be seriously explore in future research.

Journal of Economic Surveys, 2021, https://doi.org/10.1111/joes.12466


Abstract: This paper investigates the impact of delaying retirement on mortality among the French population. We take advantage of the 1993 pension reform in the private sector to identify the causal effect of an increase in claiming age on mortality. We use administrative data which provide detailed information on career characteristics, dates of birth and death. Our results, precisely estimated, show that an exogenous increase of one year in the claiming age has no significant impact on the probability to die. To test the power of our sample to detect statistically significant effects for rare events like death, we compute minimum detectable effects (MDE). Our MDE estimates suggest that, if an impact of later retirement on mortality would be detectable, it would remain very small in magnitude.

Health Economics, 2021, https://doi-org/10.1002/hec.4240 


Book Chapters and Other Publications


Abstract: This chapter provides an overview of the German long-term care insurance. We document care needs and wellbeing of the elderly population. Moreover, we provide a detailed description of the German long-term care institutions (sources of finance and types of benefits), the professional care work force, and informal caregivers. Finally, we document expenditures on long-term care and estimate the value of informal care. The cost of long-term care for the elderly (65+), including both cost of nursing home and home health agency, reached 61 billion euro in 2019. Half of these spending are for nursing homes while only about 22.5% of beneficiaries use these institutions. Out-of-pocket spending differs greatly between modes of care. Out-of-pocket expenditures make up only about 7% of total expenditures for home care. In nursing homes, 41% of expenditures are out-of-pocket payment. Most of the expenditures are covered by the long-term care insurance. The share of other governmental schemes in expenditures for inpatient care is relatively high. This is explained by a high rate of benefit recipients who cannot afford co-payments for nursing homes: about one-third of all nursing home residents receive means- and wealth-tested social assistance. If we add the costs of informal care the share of privately financed care amounts to nearly 60% of total expenditures. 

NBER Working Paper, 2023, n°31870 , doi:10.3386/w31870  

Long-Term Care in Germany, Johannes Geyer, Axel Börsch-Supan, Peter Haan, Elsa Perdrix. in Long-Term Care around the World, Gruber and McGarry. 2024 (Forthcoming).

Abstract: This chapter reviews the literature about the effect of retirement on well-being. It distinguishes studies that investigate the consequences of retirement on measures of well-being such as happiness and life satisfaction from those focusing on mental health. Special attention is also paid to the estimation method and the identification strategy. While results based on mental health or measures of well-being are remarkably consistent, they are sensitive to the estimation methods. While, on average, retired individuals report a lower level of well-being than workers, results based on causal methods tend to indicate that the effect of retirement on well-being is non negative. 

in Handbook of Labor, Human Resources and Population Economics , 2023, https://doi.org/10.1007/978-3-319-57365-6_391-1


Papier de vulgarisation scientifique à destination d'un public principalement médical.
Abstract: Dans cette revue, nous présentons les principaux résultats obtenus dans la littérature économique en nous focalisant sur l’effet causal de la retraite sur la santé, et non l’inverse.

médecine/sciences n° 12, vol. 36, décembre 2020. https://doi.org/10.1051/medsci/2020225


Working Papers & Work in Progress

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