Thomas Barnay
Université Paris-Est Créteil, Erudite, Faculty Member
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The absence of disease or disability and active involvement in society are considered as essential dimensions of successful ageing. To assess these concepts, we propose a new indicator the Healthy Working Life Expectancy (HWLE) that... more
The absence of disease or disability and active involvement in society are considered as essential dimensions of successful ageing. To assess these concepts, we propose a new indicator the Healthy Working Life Expectancy (HWLE) that associates health status and productive engagement, in order to compare various situations in Europe. The study population is drawn from the European Community Household Panel (ECHP) which is the unique source of longitudinal data, providing comparable information between 1995 and 2001 on health and work statuses for a sample of some 60,000 household's representative of the population of: Austria, Belgium, Denmark, Finland, France, Germany, the United Kingdom, Greece, Italy, the Netherlands, Portugal, and Spain. Based on the multi-state life table approach conventionally used for calculating healthy life expectancies, the HWLE corresponds to the number of years spent between the ages of 50 and 70 both in good health and at work. In average, among the 20 years available between age 50 and age 70, the HWLE is 7.5 years for men and 4.8 years for women, ie, one half and one third respectively of the number of years spent in good health (14.1 and 13.5 years). The countries where the healthy working life expectancy of seniors is the highest are also the countries where the levels of employment of seniors are higher. Conversely, health status has only a weak influence on the HWLE indicator. These findings suggest the existence of a reservoir of healthy years which can be used to increase the length of the working life expectancy. They underline also the essential role that employment maintenance and retirement policies should have to increase the number of healthy years spent at work, and therefore guarantee a successful ageing for the seniors in Europe.
Research Interests: Psychology, Demography, Gerontology, Aging, Health, and 15 moreEmployment, Medicine, Humans, Europe, Female, Pubmed, Male, Life Expectancy, Health Status, Aged, Middle Aged, Health Indicator, I, D, and Life tables
Numerous studies have shown that state of health is a powerful factor of discrimination between social categories and between the sexes. Our study, based on data from the complementary employment survey, confirms these results. It focused... more
Numerous studies have shown that state of health is a powerful factor of discrimination between social categories and between the sexes. Our study, based on data from the complementary employment survey, confirms these results. It focused on the working population aged between 50 and 64. We use the multidimensional analysis method to construct a typology of quality of life based on social category and gender, thus identifying homogeneous groups of individuals. We then examine how these health inequalities should be taken into account in the granting of pension entitlements. This study is in two parts. The first aims to characterize the quality of life of this population (share of the affected population in the general population, effects of ageing on the affected population, type, accumulation and gravity of health problems) defined on the basis of three types of question: questions concerning visual handicaps, deafness, mobility and other problems (qualified by the handicap indicat...
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PURPOSE The intended clinical value of frailty screening is to identify unfit patients needing geriatric assessment (GA) and to prevent unnecessary GA in fit patients. These hypotheses rely on the sensitivity and specificity of screening... more
PURPOSE The intended clinical value of frailty screening is to identify unfit patients needing geriatric assessment (GA) and to prevent unnecessary GA in fit patients. These hypotheses rely on the sensitivity and specificity of screening tests, but they have not been verified. METHODS We performed a cross-sectional analysis of outpatients age ≥ 70 years with prostate, breast, colorectal, or lung cancer included in the ELCAPA cohort study (ClinicalTrials.gov identifier: NCT02884375 ) between February 2007 and December 2019. The diagnostic accuracy of the G8 Geriatric Screening Tool (G8) and modified G8 scores for identifying unfit patients was determined on the basis of GA results. We used decision curve analysis to calculate the benefit of frailty screening for detecting unfit patients and avoiding unnecessary GA in fit patients across different threshold probabilities. RESULTS We included 1,648 patients (median age, 81 years), and 1,428 (87%) were unfit. The sensitivity and specifi...
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The efficiency objective of the healthcare system and the necessity to deal with a locally lacking of medical healthcare suppliers (equity objective) has driven the initial model of practices’physicians to evolve. The implementation of a... more
The efficiency objective of the healthcare system and the necessity to deal with a locally lacking of medical healthcare suppliers (equity objective) has driven the initial model of practices’physicians to evolve. The implementation of a gatekeeper, the concentration of activity and experiments in sharing responsibilities characterise this trend and herald the advent of a new model for outpatient services, thus gradually calling into question the principles of the self-employed doctors’charter. Despite this strong trend, some rules from the old model have endured, notably with the practically exclusive conservation of fee-for-service and the freedom of establishment. Beginning with the “family doctor” reform, this contribution aims to analyse this transformation, the issues it highlights and also the associated contradictions. The impact of this reform on new forms of organisation, the tools for regulation and the territorial discrepancies in healthcare offers are analysed in relati...
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Le systeme de sante francais repute tres curatif est-il pret a une inflexion vers davantage de prevention ? Tout porte a priori a le croire. La Strategie nationale de sante portait deja l’ambition forte de « faire le choix de la... more
Le systeme de sante francais repute tres curatif est-il pret a une inflexion vers davantage de prevention ? Tout porte a priori a le croire. La Strategie nationale de sante portait deja l’ambition forte de « faire le choix de la prevention, levier majeur de reduction de la mortalite et de la morbidite evitables ». Dans cette dynamique, la loi de modernisation de notre systeme de sante votee en 2015 met la prevention au cœur du dispositif en affirmant « prevenir avant d’avoir a guerir » (intitule du premier axe). Cette injonction est declinee dans les differents plans tels que le troisieme Plan cancer (2014-2019) ou le Plan National Sante Environnement (PNSE 3) (2015-2019), en lien etroit avec la lutte contre les inegalites sociales de sante. L’introduction d’un paiement a la performance en complement du paiement a l’activite vise, en outre, a modifier les pratiques des medecins et inciter a davantage d’actes preventifs...
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Reforms of the French pay-as-you-go pension system relies on increases in the contribution period, gradually postponing legal retirement ages. Several works analyse the effect of these reforms on employment rate or the financial... more
Reforms of the French pay-as-you-go pension system relies on increases in the contribution period, gradually postponing legal retirement ages. Several works analyse the effect of these reforms on employment rate or the financial equilibrium of pension scheme. The effect of transitioning into retirement on health status has not received the same attention. In order to assess the role of retirement on physical and mental health status, we use data coming from the French Health and Professional Route survey (Sip, “Santé et itinéraire professionnel”) and address the methodological issues (endogeneity biases such as reverse causality and unobserved characteristics) by setting up an instrumental variables method relying on discontinuities induced by legal ages of retirement. Unaccounting for endogeneity biases, we do not find any significant effect of retirement on health status as a whole. When instrumenting by legal ages of retirement, we find consistent and large effects on activity li...
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This study analyses the causal impact of long-term handicaps relative to short-term handicaps on employment status in the short and medium run (1-5 years), by taking into account the effects of activity sector (public or private), gender... more
This study analyses the causal impact of long-term handicaps relative to short-term handicaps on employment status in the short and medium run (1-5 years), by taking into account the effects of activity sector (public or private), gender and handicap origin (accidents or diseases). We uses the Health and Professional Career survey ( Sante et Itineraires Professionnels - S IP ), conducted in France in 2006-2007, in order to evaluate the effect of long-term handicaps on individual’s career. In this perspective, we build an individual/year panel and used the difference-in-differences with exact matching method by distinguishing according to the sector of activity (public or private). We proceed with matching including lagged effects of activity so as to control for the endogeneity between employment and handicaps’ onset. Men and women are not affected in the same way by short-term handicaps, men’s jobs being more threatened that those of women. Moreover, long-term handicaps seem to hav...
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In France, the 1987 Law set up a legal quota of disabled workers in more than 20 employees companies. In order to encourage employers to better promote the employment of disabled people, this law decreed financial penalties for... more
In France, the 1987 Law set up a legal quota of disabled workers in more than 20 employees companies. In order to encourage employers to better promote the employment of disabled people, this law decreed financial penalties for non-compliance. The aim of this paper is to evaluate the impact of this law on the employment of disabled people. We use a double difference approach combined with dynamic exact matching and weighting methods in order to disentangle the pure effect of the legislation by controlling for both observable and unobservable correlated heterogeneities. Using a panel data set built from the “Santé et itinéraire professionnel” (lit. Health and Labour Market Histories) survey conducted in France in 2006-2007, we investigate whether disabilities have a significant impact on people’s employment, by distinguishing between the public and private sectors. We compare the labour trajectories of disabled people before (1968-1986) and after (19882006) the implementation of the ...
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The links between health and work are definitely a major public policy issue, notably, in terms of retirement, public health, and employment. Economic analyses have focused on measuring both the impact of health on employment and the... more
The links between health and work are definitely a major public policy issue, notably, in terms of retirement, public health, and employment. Economic analyses have focused on measuring both the impact of health on employment and the effect of working conditions on health. Poor health clearly appears to impede professional activity and may cause earlier retirement. In addition to public health measures designed to improve the overall health of the population, these studies raise questions about the specific role of work environment in preserving employees’ health. Nevertheless, the evaluation of occupational and safety health measures is hindered by under-reporting and under-recognition of occupational injuries and illnesses. Overcoming these obstacles remains a challenge for economic analyses.
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since 1950? A time-series study with structural breaks and non-linearity approaches
Disparities in taking sick leave between sectors of
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Linear-assisted switching (PWM) converters have advantages over single switching topologies, mainly because of the reduction or elimination of bulky output capacitors and ultra-fast dynamical response. In this paper, a linear-assisted... more
Linear-assisted switching (PWM) converters have advantages over single switching topologies, mainly because of the reduction or elimination of bulky output capacitors and ultra-fast dynamical response. In this paper, a linear-assisted zeta converter is presented. The linear regulator circuit is composed by three bipolar transistors and an operational amplifier, which drives the transistor based on the error between the output voltage and its reference. The modeling of the whole circuit is presented, as well as a design example. The modeling of the zeta converter is similar to the conventional topology modeling, except the fact that the linear regulator current is considered as an extra state that substitutes the state regarding the output capacitor voltage. The zeta converter can be designed independently of the linear regulator circuit and simulations are used to validate the static operation of the overall topology. Experimental results confirm in practice the ripple compensation ...
Research Interests: Computer Science and IEEE
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This report examines the shortand medium-term effects of cancer on employment and activity. It uses the Hygie database, produced by IRDES from the administrative data of the Caisse nationale de l'Assurance maladie (French National... more
This report examines the shortand medium-term effects of cancer on employment and activity. It uses the Hygie database, produced by IRDES from the administrative data of the Caisse nationale de l'Assurance maladie (French National Health Insurance Scheme) and the Caisse nationale d'assurance vieillesse (French National Pension Fund). Hygie reconstructs the individual's career as well as health events. The first part exploits the retrospective career dimension and confirms the penalizing effect of cancer on activity and the increase in sick leave. The results of a double-difference model with accurate matching show the persistence of the disease's effects on labour market remoteness, with the probability of being employed at least one quarter of the year decreasing to a five-year horizon. We also measure the effect of the 12 most prevalent cancers in the Hygie database and chronic diseases with a potential impact on the labour market. The most marked effects are relat...
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The pension system is complex because, on the one hand, the Act of 2003 imposes equality in terms of the contribution period for both private-sector employees and civil servants and, on the other, a plethora of different rules governs... more
The pension system is complex because, on the one hand, the Act of 2003 imposes equality in terms of the contribution period for both private-sector employees and civil servants and, on the other, a plethora of different rules governs retirement entitlements. The average age of retirement actually varies significantly according to level of education, occupational category and pension scheme. For example, managers, self-employed tradespeople and farmers retire later than manual workers. Furthermore, state of health at the end of working life is particularly poor for some occupational categories, such as manual workers. One of the causes of this social inequality with respect to health is harsh work performed during working life. This article examines the legitimacy of introducing positive discrimination in terms of retirement entitlements on the basis of health, more specifically according to harshness of work. This legitimacy is examined from three points of view: philosophical, leg...
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La revue Economie et Statistique a choisi de consacrer ce numero a des travaux mobilisant l’enquete Sante et itineraire professionnel mise en place par la Direction de la recherche, des etudes, de l’evaluation et des statistiques (Drees)... more
La revue Economie et Statistique a choisi de consacrer ce numero a des travaux mobilisant l’enquete Sante et itineraire professionnel mise en place par la Direction de la recherche, des etudes, de l’evaluation et des statistiques (Drees) du Ministere des Affaires sociales et de la sante et la Direction de l’animation de la recherche, des etudes et des statistiques (Dares) du Ministere du travail, de l’emploi, de la formation professionnelle et du dialogue social...
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The guidelines on prostate cancer treatment in older men recommend evaluating the patient’s underlying health status before treatment selection. We aimed to evaluate the frequency of a guideline–discordant treatment (GDT), identify... more
The guidelines on prostate cancer treatment in older men recommend evaluating the patient’s underlying health status before treatment selection. We aimed to evaluate the frequency of a guideline–discordant treatment (GDT), identify factors associated with GDT, and assess the relationship between GDT and overall survival. We studied patients with prostate cancer aged 70 or older included in the ELCAPA cohort between 2010 and 2019. Multivariable logistic regression assessed GDT-associated factors. The restricted mean survival time (RMST) assessed the 24- and 36-month OS using stabilized inverse probability of treatment weighting of propensity scores. We included 356 patients (median age: 81 years), and 164 (46%) received a GDT (95% confidence interval (CI) = (41–51%)). Patients with metastases were less likely to receive a GDT (adjusted odds ratio (95% CI) = 0.34 (0.17–0.69); p = 0.003). After weighting, the RMST at 24 months was shorter in the GDT group (13.9 months, vs. 17 months fo...
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PurposeThe purpose of this paper is to estimate a reduced form model of expectations-based reference-dependent preferences to explain job retention of older workers in Europe in the context of the 2009 economic... more
PurposeThe purpose of this paper is to estimate a reduced form model of expectations-based reference-dependent preferences to explain job retention of older workers in Europe in the context of the 2009 economic crisis.Design/methodology/approachUsing individual micro-economic longitudinal data from the Survey of Health, Ageing, and Retirement in Europe between 2006 and 2011, the authors derive a measure of “good, bad or no surprise” from workers’ anticipated evolution of their standard of living five years from 2006 (reference point) and from a comparison of their capacity to make ends meet between 2006 and 2011.FindingsThe authors find that the probability to remain on the labour market in 2011 is significantly higher for individuals who experienced a lower than expected standard of living. The effect of a “bad surprise” on job retention is larger than the effect of a “good surprise” once netted out from the effects of expectations at baseline, change in consumption utility, and th...
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The assumption according to which ill individuals can be replaced at work that underpins the ‘friction cost method’ (FCM) to value productivity costs has been primarily discussed within the framework of cost-utility analysis. This paper... more
The assumption according to which ill individuals can be replaced at work that underpins the ‘friction cost method’ (FCM) to value productivity costs has been primarily discussed within the framework of cost-utility analysis. This paper investigates the consequences of this assumption for cost-benefit analysis (CBA). It makes three contributions. First, it provides the first analytical account of the overall consequences of ill worker replacement on social welfare and it analyzes the associated compensation effects within a CBA framework. Second, it highlights a double counting problem that arises when ill worker replacement is assumed in the CBA of life-saving health care programs. To the best of our knowledge, no satisfactory solution to this problem has yet been provided in the literature. Third, this paper suggests and discusses two original ways to address this double counting issue. One consists in adjusting value of a statistical life estimations for the well-being provided b...
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Reforms of the French pay-as-you-go pension system relies on increases in the contribution period, gradually postponing legal retirement ages. Several works analyse the effect of these reforms on employment rate or the financial... more
Reforms of the French pay-as-you-go pension system relies on increases in the contribution period, gradually postponing legal retirement ages. Several works analyse the effect of these reforms on employment rate or the financial equilibrium of pension scheme. The effect of transitioning into retirement on health status has not received the same attention. In order to assess the role of retirement on physical and mental health status, we use data coming from the French Health and Professional Route survey (Sip, "Santé et itinéraire professionnel") and address the methodological issues (endogeneity biases such as reverse causality and unobserved characteristics) by setting up an instrumental variables method relying on discontinuities induced by legal ages of retirement. Unaccounting for endogeneity biases, we do not find any significant effect of retirement on health status as a whole. When instrumenting by legal ages of retirement, we find consistent and large effects on a...
En France, les maladies cardiovasculaires (MCV) representent la premiere cause de mortalite chez les femmes. Le role du milieu professionnel dans l'apparition de ces pathologies est peu documente. L'objectif de cette etude est... more
En France, les maladies cardiovasculaires (MCV) representent la premiere cause de mortalite chez les femmes. Le role du milieu professionnel dans l'apparition de ces pathologies est peu documente. L'objectif de cette etude est d'evaluer l'effet de l'exposition aux contraintes physiques du travail sur la declaration de MCV chez les femmes. Materiel et methode – A partir des donnees de l'enquete Sante et itineraire professionnel (SIP), qui fournit des informations detaillees sur les conditions de travail, l'etat de sante et la carriere des individus, nous avons utilise des indicateurs relatifs au travail de nuit, a la repetitivite, a la charge physique et a l'exposition aux toxiques, declares en 2006. Nous avons ensuite utilise un indicateur combine rendant compte des expositions sur l'ensemble de la carriere. Une modelisation de type Logit binomial a ete realisee sur 2 780 femmes et 2 633 hommes en emploi en 2006, en vue d'analyser la prevalenc...
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This article aims to measure the net effect of physical and psychosocial working conditions, throughout their entire professional career, on retirees’ self-assessed physical and mental health, and drug consumption. Based on the French... more
This article aims to measure the net effect of physical and psychosocial working conditions, throughout their entire professional career, on retirees’ self-assessed physical and mental health, and drug consumption. Based on the French Health and Career Path (Sante et Itineraire Professionnel) survey, we control our regressions for socioeconomic characteristics, employment, career path, past individual characteristics on entering the labour market, and past health status. Our results highlight the negative role of exposure to detrimental working conditions on retirees’ physical and mental health, evidencing a clear relationship between physical constraints and physical health on the one hand, and between psychosocial risk factors and mental health (including drug consumption) on the other hand. These findings underline the long-term effect of difficult working conditions on health status, even after retirement.
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Reforms of the French pay-as-you-go pension system relies on increases in the contribution period, gradually postponing legal ret irement ages. Several works analyse the effect of these reforms on employment rate or the f inancial... more
Reforms of the French pay-as-you-go pension system relies on increases in the contribution period, gradually postponing legal ret irement ages. Several works analyse the effect of these reforms on employment rate or the f inancial equilibrium of pension schemes. The effect of retirement on health status has not r eceived the same attention. In order to assess the role of retirement on physical and mental healt status, we use data coming from the French Health and Professional Path survey (Sip, “S anté et itinéraire professionnel”) and address the methodological issues (endogeneity bias es such as reverse causality and unobserved characteristics) by setting up an instru mental variables method relying on discontinuities induced by legal ages of retirement . Unaccounting for endogeneity biases, we do not find any significant effect of retirement on health status as a whole. When instrumenting by legal ages of retirement, we find consistent and large short-term effects on activity limi...