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

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  • Eric French
  • Elaine Kelly
  • Christelle Gastaldi‐Ménager
  • Pierre‐Yves Geoffard
  • Grégoire de Lagasnerie
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.
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Suggested Citation

  • Eric French & Elaine Kelly & Christelle Gastaldi‐Ménager & Pierre‐Yves Geoffard & Grégoire de Lagasnerie, 2016. "Medical Spending in France: Concentration, Persistence and Evolution before Death," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 499-526, September.
    • Handle: RePEc:ifs:fistud:v:37:y:2016:i::p:499-526
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    File URL: http://hdl.handle.net/10.1111/
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    Cited by:

    1. Audrey Tanguy-Melac & Dorian Verboux & Laurence Pestel & Anne Fagot-Campagna & Philippe Tuppin & Christelle Gastaldi-Ménager, 2021. "Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1039-1052, September.
    2. Hua Chen & Xiaobo Peng & Menghan Shen, 2021. "Concentration and Persistence of Healthcare Spending: Evidence from China," Sustainability, MDPI, vol. 13(11), pages 1-17, May.

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