Ventelou

Publications

Les attendus d’une approche d’économie comportementale pour les décisions individuelles face à la pandémie de COVID-19 : succès et déceptionsJournal articleThierry Blayac, Dimitri Dubois, Sebastien Duchêne, Phu Nguyen-Van, Ismael Rafai, Bruno Ventelou et Marc Willinger, médecine/sciences, Volume 38, Issue 6-7, pp. 594-599, 2022

Dans le cadre du premier appel à projet « Flash-COVID-19 » de l’Agence nationale de la recherche, nous avons mobilisé des méthodes récentes de l’économie comportementale afin de mieux comprendre les décisions des individus face à la crise sanitaire due à la pandémie de COVID-19 (<i>coronavirus disease 2019<i/>) et d’identifier les paramètres pouvant influencer le respect des mesures sanitaires. Cet article introduit brièvement l’économie comportementale, présente un compte rendu des attendus du projet CONFINOBS (Observance et observation des mesures barrières et du confinement : une approche d’économie comportementale) et de ses méthodes, puis il propose une synthèse des résultats obtenus.

Nudging for lockdown: behavioural insights from an online experimentJournal articleThierry Blayac, Dimitri Dubois, Sebastien Duchêne, Phu Nguyen-Van, Ismael Rafai, Bruno Ventelou et Marc Willinger, Social Psychology, Volume 53, Issue 3, pp. 133-151, 2022

We test the effectiveness of a social comparison nudge (SCN) to enhance lockdown compliance during the COVID-19 pandemic using a French representative sample (N = 1,154). Respondents were randomly assigned to a favorable/unfavorable informational feedback (daily road traffic mobility patterns, in Normandy - a region of France) on peer lockdown compliance. Our dependent variable was the intention to comply with a possible future lockdown. We controlled for risk, time, and social preferences and tested the effectiveness of the nudge. We found no evidence of the effectiveness of the SCN among the whole French population, but the nudge was effective when its recipient and the reference population shared the same geographical location (Normandy). Exploratory results on this subsample (N = 52) suggest that this effectiveness could be driven by noncooperative individuals.

Economics of attention: The gender-based bing communication study on depressionJournal articleYulin Hswen, Ulrich Nguemdjo, Elad Yom-Tom et Bruno Ventelou, SSM - Population Health, Volume 17, pp. 100993, 2022

This study examines the impact of personalized gender-based communication to encourage the screening of depression and seeking out mental health care consultation. An internet search engine advertisement was deployed on Bing, Microsoft during the COVID-19 pandemic lockdowns in the Provence–Alpes–Côte d'Azur (PACA) region in France during the month of May 2020, the height of the France lockdowns. A two-armed study was conducted with Arm A containing a non-personalized (control) advertisement and Arm B containing a personalized gender-based advertisement. 53,185 advertisements were shown between the two arms. Results show that receiving a personalized gender-based message increases the probability of clicking on the advertisement. However, upon clicking the advertisement, there was no significant difference in the completion of the depression questionnaire between the two groups. These results suggest that although personalized gender messaging is effective at drawing in a greater click rate, it did not increase, nor decreased, the conversion rate to monitor depression by self-assessment.

Reassessing the demand for community-based health insurance in rural Senegal: Geographic distance and awarenessJournal articleMârwan-al-Qays Bousmah, Sylvie Boyer, Richard Lalou et Bruno Ventelou, SSM - Population Health, Volume 16, pp. 100974, 2021

Limited access to information is one of the main health insurance market imperfections in developing countries. Differential access to information may determine individuals’ awareness of health insurance schemes, thereby influencing their probability of enrollment. Relying on primary data collected in 2019–2020 in rural Senegal, we estimate the uptake of community-based health insurance using a Heckman-type model to correct for awareness-based sample selection bias. Besides showing that health insurance awareness is a precondition for effective enrollment in community-based health insurance schemes, we also bring new evidence on the roles which geographic factors and individual risk preference play in health insurance uptake by rural dwellers. We show that geographic distance prevents individuals from accessing information on health insurance schemes, and discourage those who are informed from enrolling, because of the additional distance they must travel to benefit from covered healthcare services. Results also show that individual risk preference influences health insurance uptake, but only when information barriers are taken into account. Overall, our results could help decision-makers better shape the universal health coverage roadmap, as policies to improve health insurance awareness differ substantially from policies to improve the features of health insurance schemes.

Vers une couverture sanitaire universelle au Sénégal : quelles sont les meilleures stratégies de financement ?Journal articleSameera Awawda, Mohammad Abu-Zaineh et Bruno Ventelou, Revue internationale des études du développement, Volume 247, Issue 3, pp. 37-60, 2021

Cette étude a pour objectif d’évaluer différents modes de financement de la couverture santé universelle au Sénégal. La méthode utilisée, la micro-simulation, permet d’examiner l’impact de différents scenarii sur les consommations des ménages ainsi que sur les dépenses publiques. Les résultats montrent que la généralisation d’une assurance-maladie à l’ensemble de la population, associée à une réduction des coûts directs des soins, augmenterait les consommations de soins des Sénégalais, améliorant donc leur accès aux services de santé. Néanmoins, une telle généralisation serait coûteuse pour les finances publiques. Pour limiter les coûts supportés par le gouvernement, l’augmentation du taux d’imposition sur la consommation et de la prime de contribution à l’assurance-maladie serait utile et permettrait de ramener les finances publiques à l’équilibre.

Comment les migrations affectent-elles la mortalité infanto-juvénile en zone rurale ? L’exemple de Niakhar, SénégalJournal articleUlrich Nguemdjo et Bruno Ventelou, Population, Volume 76, Issue 2, pp. 359-387, 2021

Explorant les riches données longitudinales fournies par l’Observatoire de santé et de population de Niakhar, cette étude examine les effets des migrations sur la mortalité infanto-juvénile dans les familles rurales restées au village. Les migrations, en particulier de courte durée, sont associées de manière positive aux chances de survie des enfants de moins de cinq ans au sein du ménage. On constate également que les déplacements de courte durée des femmes d’âge actif ont plus d’incidences sur la mortalité des enfants que ceux de leurs homologues masculins. De surcroît, des effets croisés sont identifiés entre ménages de la même concession, ce qui est conforme à l’idée que les familles rurales africaines partagent les gains de l’émigration avec une communauté étendue de voisins. Enfin, l’effet des migrations maternelles de courte durée sur la survie des enfants de moins de cinq ans demeure globalement positif, mais nettement plus modeste. L’émigration de la mère, en particulier pendant la grossesse, semble améliorer la probabilité de survie des enfants juste après la naissance, mais celle-ci tend à diminuer après l’âge d’un an et lorsque la mère est absente.

Physicians’ incentives to adopt personalised medicine: Experimental evidenceJournal articleDavid Bardey, Samuel Kembou et Bruno Ventelou, Journal of Economic Behavior & Organization, Volume 191, pp. 686-713, 2021

We study physicians’ incentives to use personalised medicine techniques, replicating the physician’s trade-offs under the option of personalised medicine information. In a laboratory experiment conducted in two French Universities, prospective physicians played a real-effort game. We vary both the information structure (free access versus paid access to personalised medicine information) and the payment scheme (pay-for-performance (P4P), capitation (CAP) and fee-for-service (FFS)), implementing a within-subject design. Our results are threefold: (i) Compared to FFS and CAP, the P4P scheme strongly and positively impacts the decision to adopt personalised medicine. (ii) Although expected to dominate the other schemes, P4P is not always efficient in transforming free access to personalised medicine into higher quality of care. (iii) When it has to be paid for and after controlling for self-selection, personalised medicine is positively associated with quality, suggesting that subjects tend to make better use of information that comes at a cost. We find this effect to be stronger for males than for females prospective physicians. Quantification of our results however suggests that this positive impact is not strong enough to justify generalising the payment for personalised medicine access. Finally, we develop a theoretical model that includes in its set-up a commitment device component, which is the mechanism that we inferred from the data of the experiment. Our model replicates the principal results of the experiment, reinforcing the interpretation that the higher quality provided by subjects who bought personalised medicine can be interpreted as a commitment device effect.

Does Self-Assessed Health Reflect the True Health State?Journal articlePavitra Paul, Ulrich Nguemdjo, Natalia Kovtun et Bruno Ventelou, International Journal of Environmental Research and Public Health, Volume 18, Issue 21, pp. 11153, 2021

Self-assessed health (SAH) is a widely used tool to estimate population health. However, the debate continues as to what exactly this ubiquitous measure of social science research means for policy conclusions. This study is aimed at understanding the tenability of the construct of SAH by simultaneously modelling SAH and clinical morbidity. Using data from 17 waves (2001–2017) of the Russian Longitudinal Monitoring Survey, which captures repeated response for SAH and frequently updates information on clinical morbidity, we operationalise a recursive semi-ordered probit model. Our approach allows for the estimation of the distributional effect of clinical morbidity on perceived health. This study establishes the superiority of inferences from the recursive model. We illustrated the model use for examining the endogeneity problem of perceived health for SAH, contributing to population health research and public policy development, in particular, towards the organisation of health systems.

Online study of health professionals about their vaccination attitudes and behavior in the COVID-19 era: addressing participation biasJournal articlePierre Verger, Dimitri Scronias, Yves Fradier, Malika Meziani et Bruno Ventelou, Human Vaccines & Immunotherapeutics, Volume 17, Issue 9, pp. 2934-2939, 2021

Online surveys of health professionals have become increasingly popular during the COVID-19 crisis because of their ease, speed of implementation, and low cost. This article leverages an online survey of general practitioners’ (GPs’) attitudes toward the soon-to-be-available COVID-19 vaccines, implemented in October–November 2020 (before the COVID-19 vaccines were authorized in France), to study the evolution of the distribution of their demographic and professional characteristics and opinions about these vaccines, as the survey fieldwork progressed, as reminders were sent out to encourage them to participate. Focusing on the analysis of the potential determinants of COVID-19 vaccine acceptance, we also tested if factors related to survey participation biased the association estimates. Our results show that online surveys of health professionals may be subject to significant selection bias that can have a significant impact on estimates of the prevalence of some of these professionals’ behavioral, opinion, or attitude variables. Our results also highlight the effectiveness of reminder strategies in reaching hard-to-reach professionals and reducing these biases. Finally, they indicate that weighting for nonparticipation remains indispensable and that methods exist for testing (and correcting) selection biases.

Reçoit-on les mêmes soins partout en France ? La question de l’hétérogénéité des pratiques, de leur raison d’être et de leur contrôleBook chapterAlain Paraponaris et Bruno Ventelou, In: Le système de santé français aujourd'hui : enjeux et défis, T Barnay, A.-L. Samson et B. Ventelou (Eds.), 2021-07, pp. 157-176, EP Eska Publishing, 2021

La crise de la COVID-19 a souligné, parfois avec cruauté, certaines insuffisances du système de santé français. Elle a mis en lumière l’absence de stratégie globale de gestion du risque et la difficulté de prendre des décisions adaptées à un niveau infranational. Mais elle a aussi été porteur d’espoir en révélant une véritable capacité d’adaptation des professionnels de santé à l’hôpital et en ville et des industriels pharmaceutiques, accélérant les processus d’innovation thérapeutique et de coordination des acteurs.

Il semble, aujourd’hui plus que jamais, nécessaire qu’un ouvrage en économie de la santé puisse éclairer les débats qui traversent le système de santé. De nombreux défis sont à relever : le financement et la régulation des dépenses de santé, le manque de coordination entre médecine de ville et hôpital ; le déficit de prévention et l’invisibilité de la santé publique ; les inégalités sociales de santé et d’accès aux soins. Ces défis interrogent chacun des acteurs du système de santé (patients, offreurs de soins, industriels…).

A l’occasion de ses 30 ans, le Collège des Economistes de la santé propose un ouvrage collectif réunissant 30 contributeurs, et ambitionne d’analyser et de disséquer les principaux défis auxquels le système de santé fait face.