Working papers and ongoing work

• "I care, you clean? Gendered effects of informal care on couple housework and leisure time [WP available]", with Marie Blaise, Sandrine Juin, Hélène Le Forner

• "Income Gradients in Health-State Dependence", with Philippe de Donder, Mathieu Lefebvre, Marie-Louise Leroux

This paper investigates how marginal utility varies with health status (e.g. health-state dependence) while allowing this relationship to differ across income levels. Building on the existing literature, we develop a framework that quantifies the income adjustments necessary to maintain individuals’ well-being when they become disabled. Using SHARE data, we empirically estimate how health affects the marginal utility of consumption across the income distribution for older adults in Europe. Our results show that health-state dependence is negative among low-income individuals, indicating that their marginal utility of consumption declines when their health worsens. In contrast, at the very top of the income distribution, health-state dependence is positive, implying that marginal utility of consumption rises as health deteriorates.   

• Informal caregiving and preventive health behaviors in Europe, with Alexandre Prachant

• "Gender gap in informal caregiving among the 50+ population in Europe", with Mathieu Lefebvre

We analyze the gender gap in informal caregiving in Europe for the 50+ population. Using data from the lastst wave of the Survey on Health, Ageing and Retirement (2022), we analyse the determinants of informal caregiving and implement an Oaxaca-Blinder decomposition explaining differences between probabilities of being caregivers for women and men. It shows that the gender difference of 10 percentage points is not driven by differences of characteristics (explained part of the difference) but rather by the coefficient effect (unexplained). This result is remarkably stable across time, education and income levels, employment status and welfare state models. They confirm persistent differences in the caregiving behaviors between men and women.  

• "How do physician prices and activity respond to competition? The role of the shortage context", with Matthieu Cassou, Carine Franc

This paper explores how competition affects the activity and prices of gynaecologists providing outpatient care in France, taking into account the initial supply on the market. It takes advantage of recent changes in this market, with a high number of midwives entering the market with an increasingly overlapping scope of practice with gynaecologists and a steady decline in the number of gynaecologists over the same period. We first derive a model of care provider differentiation in waiting times to explore the specifics of market interaction in a context of shortage. Contrasting with the canonical expectation, the model provides a rational to price increases as a reaction to regulated provider entry, such as midwives, due to a reduction in congestion.    We empirically test the predictions with exhaustive administrative panel data on healthcare providers (CNAM-DGFiP) with 4 waves from 2011 to 2021. We estimate individual fixed-effect models, where competition is measured by a spatially smoothed measure of supply density and interacted with the level of outpatient sexual health care supply in the market area. The results show that there is a significant interaction between the density of midwives and the price charged by unregulated gynaecologists. The price reaction is non-monotonic and the canonical effect of a price decrease when competition increases is observed only in high-density areas, whereas midwives entry lead to price increase in low-density areas. Predictions and empirical results on activity are mixed. Overall, healthcare professional prices respond differently to competition depending on the context and estimating an average effect is likely to hide contrasted effects of possibly opposite signs.

• "Patient preferences in the context of scope of practice expansion: evidence from gynecological care in France" with Pauline Kergall and Jonathan Sicsic

• "Medical activity composition and inter-professional competition: the case of gynaecological care in France." with Jean-Baptiste Delaye and Magali Dumontet