This article investigates whether a cancer diagnosis can cause a permanent loss in employability. In this regard, we evaluate the impact of cancer on labor market conditions by constructing transition matrices to compare the transitions between occupational states. We obtain a set of statistics based on our estimations by using continuous-time Markov transition processes to study and compare the labor market dynamics in two populations: 1) individuals diagnosed with cancer and 2) individuals free of cancer in the general population. The consequences of cancer diagnosis were measured by the significant deviation in the transition matrix for cancer survivors in comparison to the prior matrix standardized according to the general population. We accounted for the probability that some individuals in the control group (i.e., the general population) could be diagnosed with cancer which is a key-issue in case-control studies. The absence of detailed information about the health statuses of the individuals in the control group required the implementation of the EM algorithm for maximizing the adapted likelihood function. We jointly estimated the probability of being diagnosed with cancer in the control group and the parameters of our model. Given that individuals are exposed differently to cancer depending on their activities, we stratified the dataset by socioeconomic status (SES) for two reasons: 1) to clearly distinguish between the cancer-specific effects and 2) to account for the other stigmatizing factors in the labor market that are inherent to the examined subpopulations (i.e., low- and high-SES groups). We also considered the systematic differences in the subjects' socioeconomic statuses and their abilities to return to work. We determined whether these differences are related to illness (e.g., cancer sites or prognosis) or occupation (e.g., physical demands).

Nous proposons une méthode de prédiction de l’évolution des dépenses de santé ambulatoires (i.e. non hospitalières) sous l’effet du vieillissement de la population française à l’horizon 2025. Le modèle intègre deux indicateurs d’états de santé sur lesquels chaque agent de la base de données pourra transiter, par microsimulation, créant ainsi une dynamique épidémiologique individuelle entre bonne et mauvaise santé. À l’aide d’un modèle économétrique de consommation de biens et services de santé, nous déduisons la dépense française en santé en 2025 par agrégation de la population représentative vieillie en 2025. Le support choisi pour la première application de l’outil est la base de données ESPS 2000 de l’IRDES appariée avec l’Échantillon permanent d’assurés sociaux (EPAS). Le thème traité est l’impact de changements épidémiologiques sur le montant des dépenses ambulatoires. Ces simulations ont été réalisées pour trois scénarios épidémiologiques : scénario à dynamique épidémiologique constante, vieillissement en bonne santé et vieillissement en bonne santé + progrès médical (sans prise en compte des effets prix).

Socioeconomic-related inequalities in healthcare delivery have been extensively studied in developed countries, using standard linear models of decomposition. This paper seeks to assess equity in healthcare delivery in the particular context of the occupied Palestinian territory: the West Bank and the Gaza Strip, using a new method of decomposition based on microsimulations. Besides avoiding the 'unavoidable price' of linearity restriction that is imposed by the standard methods of decomposition, the microsimulation-based decomposition enables to circumvent the potentially contentious role of heterogeneity in behaviours and to better disentangle the various sources driving inequality in healthcare utilisation. Results suggest that the worse-off do have a disproportinately greater need for all levels of care. However with the exception of primary-level, utilisation of all levels of care appears to be significantly higher for the better-off. The microsimulation method has made it possible to identify the contributions of factors driving such pro-rich patterns. While much of the inequality in utilisation appears to be caused by the prevailing socioeconomic inequalities, detailed analysis attributes a non-trivial part (circa 30% of inequalities) to heterogeneity in healthcare-seeking behaviours across socioeconomic groups of the population. Several policy recommendations for improving equity in healthcare delivery in the occupied Palestinian territory are proposed.

OBJECTIVE: Scaling up antiretroviral treatment (ART) through decentralization of HIV care is increasingly recommended as a strategy toward ensuring equitable access to treatment. However, there have been hitherto few attempts to empirically examine the performance of this policy, and particularly its role in protecting against the risk of catastrophic health expenditures (CHE). This article therefore seeks to assess whether HIV care decentralization has a protective effect against the risk of CHE associated with HIV infection. DATA SOURCE AND STUDY DESIGN: We use primary data from the cross-sectional EVAL-ANRS