IRDES Newsletter

Harkness Fellowship

The Commonwealth Fund is currently inviting applications for its Harkness Fellowships in Health Care Policy and Practice, providing a unique opportunity for mid-career health services researchers and practitioners to spend up to 12 months in the United States, conducting original research and working with leading U.S. health policy experts.
Two IRDES researchers have been awarded the Harkness Fellowship: Julien Mousquès in 2015 and Paul Dourgnon in 2016.
Deadline for receipt of applications: 11 November 2019

 More information on the Commonwealth Fund website

EHPG 2019

As part of the international EHPG European Health Policy Group, in which Zeynep Or, researcher at IRDES, participates as a member of the scientific committee, a meeting is being held on 19 and 20 September 2019 in London. This multidisciplinary, collegial and informal network aims to foster international collaboration and knowledge exchange on European health systems through biannual meetings bringing together renowned researchers and students.

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 Registrations

EUPHA Conference - European Public Health Association

IRDES is one of the local partners of the 12th Conference of the European Public Health Association (EUPHA), which this year's theme is "Building Bridges for Solidarity and Public Health". The Conference will be held in Marseille (France) from 20 to 23 November 2019.

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 Registrations

European Health Interview Survey: EHIS 2019

The Directorate for Research, Studies, Assessment and Statistics (French Ministry of Health) and IRDES are carrying out a major statistical survey on the health of the French population, from 9 April to 8 July 2019 and from early September to mid-December 2019.

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The Impact of Cancer on Employment Outcomes

Barnay T., Ben Halima M.A., Duguet E., Lanfranchi J., Le Clainche C., Regaert C., Sermet C. Co-edition IRDES / CNAM, CEET
Issues in Health Economics (238). December 2018

The onset of cancer has a negative impact on careers. In this study, the Hygie administrative database was used in order to assess the effects of several cancers - one to five years after diagnosis - on labour market status. The results show that the likelihood of being employed for at least one trimester in the year decreases significantly compared with the year preceding the onset of the illness. The decrease in employment rate lasts for up to five years after the onset of cancer, resulting, in the short term, in higher rates of sick leave, and, in the medium term, non employment. However, the magnitude of these effects varies according to the type of cancer, the cancer's severity, and the gender and age of the patient when cancer is diagnosed.
In the female population, breast cancer, which is the most common type of cancer, has a significant negative impact on employment one year after diagnosis, which lasts for five years. Ovarian cancer is distinguished by the fact that it has the most pronounced negative effect on employment in the short term. Amongst men, the onset of prostate cancer leads to a moderate decrease in employability in the short term, but which becomes more acute over time. With regard to cancer sites that are common to both sexes, lung and bronchial cancer is most detrimental to employment, whereas thyroid cancer has little impact on careers.
The contrasting negative impacts on employment reflect the severity of the illness, treatment, and sequelae, and, also probably, the measures proposed by companies to improve working conditions and employment.

Impact of a New Organization in Orthopedic Surgery on Patient's Care Pathways

IN FRENCH

Malléjac N., Or Z. (IRDES), in collaboration with Fournier C. (IRDES)

IRDES Working paper (79). June 2019

Coordination of care provided before and after a hospitalization is essential for improving the quality of patient care and efficiency of health system. Various patient-centered care protocols have been developed in the medical literature for improving patient care pathways. They are increasingly promoted and employed in healthcare facilities. In this study, we evaluate the impact of the implementation of an enhanced recovery after surgery protocol (ERP) in orthopedic surgery in private hospitals on patients' care pathways.
The data used in the analyses come from the French hospital episodes' database (PMSI-MCO) concerning patients who were admitted to hospital for hip or knee prosthesis. We assess the impact of ERP on the patient length of stay (LOS), the discharge destination (home or rehabilitation facility) and the probability of readmission at 30 and 90 days after discharge. Using difference-in-difference regressions, we compare the results of patients treated in hospitals certified as «ERP» by the French-association of enhanced recovery after surgery (Grace) with those patients treated in comparable control hospitals. We estimate the effect of ERP on patients' care pathways by controlling a number of confounding factors such as age, gender, social origin, case-mix and surrounding care supply in patients' residence area.
The patients operated in a surgery department that practices ERP have, on average, a shorter length of stay than those who are operated in a conventional surgery department (-0.4 days). These patients have a higher probability of returning home (OR 1.15), without having a greater risk of readmission. The ERP label has also a positive impact on hospital volumes through competition in quality: all else being equal, hospitals labelled as ERP has a higher activity growth compared to control clinics.

The Effects of Mass Layoffs on Mental Health

Le Clainche C. (Lille University, Lille Économie Management, UMR CNRS 9221), Lengagne P. (IRDES)

IRDES Working paper (78). May 2019

This article assesses the effects of mass layoffs on the mental health of workers remaining in plants after layoffs, using a French survey merged with administrative health insurance data covering the period 2010-2013. We rely on the consumption of psychotropic drugs prescribed by doctors as an indicator of mental health. Results show that mass layoffs induce a sizeable rise in the use of psychotropic drugs amongst job stayers: we measure an increase of 41% in psychotropic drug consumption rates amongst them after displacement, as compared with the pre-displacement period. We find evidence for a social gradient whereby employees belonging to the lowest socio-economic are more affected by the adverse effect of mass layoffs on their mental health, leading to psychotropic drug consumption, than those in the highest socio-economic groups.

Impact of a French Experiment of a Doctor-Nurse Cooperation on the General Practitioner Activity

IN FRENCH

Loussouarn C. (ERUDITE, UPEC, IRDES), Franc C. (CESP, INSERM UMR 1018, IRDES), Videau Y. (ERUDITE, UPEC), Mousquès J. (IRDES)

IRDES Working paper (77). April 2019

In many countries, policies have explicitly encouraged the integration of primary care organisations and interprofessional cooperation to improve the productive and allocative efficiency of care provision and to address the unequal geographical distribution of physicians. In France, the Social Security Department of the Ministry of Health (DSS) and a not-for-profit organisation called Asalee ("Action de sante libérale en équipe" meaning Teamwork in self-employed medical practice) set up an experiment to promote vertical integration and teamwork between general practitioners and nurses, notably based on nurses' staffing and training as well as authorisation of task substitution between general practitioners and nurses and new remuneration schemes.
This article evaluates the extension of this experiment over the period 2010-2016 by studying the joint effect of the cooperation between general practitioners and nurses, the specific organization of Asalee and the underlying economic incentives on general practitioners' activity based on the following: number of working days, patients seen at least once or listed and visits delivered (office and/or home).
We control, as much as possible, for endogeneity and reduce selection biases by using a case-control design, using exact matching method and difference-in-differences estimation methods on panel data. We highlight a positive but relatively modest effect of entering into the Asalee pilot on the number of GPs' working days (+1.2%) and a more pronounced effect on the number of patients seen (+7.55%) or listed (+6.87%). Yet, we find no effect on the number of office and home visits.

Social Network Analysis Applied to Healthcare Data: Inventory, Discussion and Perspectives

Gandré C. Summary of the ARAQNEE workshop - Analyse de Réseaux AppliQuée aux donNÉes de SantE. (Network Analysis Applied to Health Data). Analyse de réseaux pour les sciences sociales (ARCS), 2019/03, 1-13.

The Effects of the Complementary Compensation on Sickness Absence: An Approach Based on Collective Bargaining Agreements in France

Ben Halima M.A., Koubi M., Regaert C. Labour, vol. 32, Issue 3, 353-394, 2018/09 2019.
(Catégorie 3 - CNRS) - (Cat. B - Hcérès)

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... Pascale Lengagne and Christine Le Clainche, following the publication of the Working paper (78), May 2019: "The Effects of Mass Layoffs on Mental Health".

• Why is this research original in France?
• What are the main results?
• What recommendations could be made in terms of public policy?

Read the interview