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This article presents an adaptation of the labour supply model applied to the independent medical sector. First, we model simultaneous General Practitioner (GP) decisions on both the leisure time and the consultation length for two payment schemes: fixed fees and unregulated fees. The objective of this econometric study is to validate the theoretical prediction that doctors under unregulated fees may make choices about the length of patient consultations independent of their personal leisure decision. Indeed, according to our empirical results, the bidirectional link between leisure choice and consultation length – verified with fixed fees – does not hold any longer under unregulated fees. Our findings can be seen as a necessary but not a sufficient condition to legitimize unregulated fees in general practice.
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To examine the relations between density of dental practitioners (DDP) and socio-economic and demographic factors shown to affect access to dental care for the elderly.
General practitioners' (GPs') use of clinical practice guidelines (CPGs) may be influenced by various contextual and attitudinal factors. This study examines general attitudes toward CPGs to establish profiles according to these attitudes and to determine if these profiles are associated with awareness and with use of CPGs in daily practice. The authors conducted a cross-sectional telephone survey of 1,759 French GPs and measured (a) their general attitudes toward CPGs and (b) their awareness and use in daily practice of CPGs for six specific health problems. A bivariate probit model was used with sample selection to analyze the links between GPs' general attitudes and CPG awareness/use. The authors found three GP profiles according to their opinions toward CPGs and a positive association between these profiles and CPG awareness but not use. It is important to build awareness of CPGs before GPs develop negative attitudes toward them.
Objectives To assess the risk of leaving employment for cancer survivors 2 years after diagnosis and the role of workplace discrimination in this risk.Methods A representative sample of 4270 French individuals older than 17 and younger than 58 years when diagnosed with cancer in 2002 were interviewed 2 years later. Their occupational status was analyzed with the help of Probit and IV-Probit models.Results Overall, 66% of the cancer survivors who were working at the time of diagnosis were still employed 2 years later. Age, education level, income at diagnosis, work contract, professional status, affective support, relative prognosis at diagnosis, tumor site and treatment have contrasting impacts upon the probability of job loss across gender. Even after having controlled for these variables, self-reported workplace discrimination increases the probability of job loss by 15%.Conclusions Despite protective labor law and favorable health insurance arrangements, French cancer survivors continue to experience problems to stay in or to return to the labor force. Measures targeting only the employment protection of cancer survivors do not seem to be sufficient to end prior social inequalities in job attainment. Intervention for specific populations particularly exposed to job-loss risks would also be needed.
A bivariate probit model with sample selection is used to estimate the conditional probability of reporting a need for personal assistance (NPA) with at least one activity of daily living among French community-dwelling elderly. 71.8% of men and 77.3% of women reported impairments and among those who reported impairments, 7.5% of men and 10.8% of women reported NPA. NPA is associated not only with age (i.e., the oldest individuals, for women only) and health status (such as a specific type of impairment), but also with socioeconomic (living with intermediate income; living with someone, partner or other) and environmental factors (having and using assistive technologies).
Most of population health surveys appeal to proxy respondents, when surveyed persons with poor health are not able or do not want to answer the questionnaire by themselves. Yet, it may give rise to a strong endogeneity problem since the use of a proxy respondent is likely to be linked to subjects’ health status. That paper aims at giving a convenient and tractable way to cope with the twofold potential endogeneity of the respondent status in the estimation of two probit equations concerning the need for care with daily activities and unmet or undermet need reported by people aged 60 years and over living in the community. Unlike previous papers dealing with that topic, evidence is found that proxy respondents do not entail any subjectivity when they assess old people’s need for care but they seem to overestimate undermet and unmet need. Classification JEL : C35 ; I12 ; J14.
Cancer survivors frequently shift to part-time job, unemployment and early retirement, probably more than the general population. We re-evaluated the impact of cancer in the labour market, using ?comparative? transition matrices between occupational states. The proper consequences of cancer were measured by a significant deviation of the transition matrix for cancer survivors, compared to a prior matrix standardised on the general population. The methodology was declined with stratifications by social class or gender. We disentangle whether systematic differences in socioeconomic status regarding ability to return to work, are illness related (cancer sites or diagnosis prognosis), or job related (physical demands). Results of the paper are in favour of a specific concern of the policy-maker towards manual workers affected by cancer. JEL classification: I10 ; J210 ; J24.