Publications
We analyze regional inequalities in access to maternal and neonatal health services in Iraq and Syria during the period 2000–2011, before the rise of the Islamic State in Iraq and Syria, ISIS. Utilizing nationally representative survey data (Iraq 2000, 2006, 2011; Syria 2006, 2009), we examine changes in the rate of babies weighed at birth and women delivering at home. We calculate 4 regional inequality indicators: (1) extremal quotient, (2) interquartile quotient, (3) coefficient of variation, and (4) systematic component of variation. Despite national improvements in both countries over time, indicators show increasing regional inequalities in access to maternal and neonatal health services, particularly in Syria between 2006 and 2009. Spatial regression results indicate that these inequalities associate with inequalities in maternal education, rurality, and wealth. Regions where women experienced deteriorating access over time, reflecting overall inequalities, are those that fell under the control of ISIS. Inequalities in access to basic services (education and health) deserve more attention in understanding social and political change in the Arab region.
We consider tests of the hypothesis that the tail of size distributions decays faster than any power function. These are based on a single parameter that emerges from the Fisher–Tippett limit theorem, and discriminate between leading laws considered in the literature without requiring fully parametric models/specifications. We study the proposed tests taking into account the higher order regular variation of the size distribution that can lead to catastrophic distortions. The theoretical bias corrections realign successfully nominal and empirical test behavior, and inform a sensitivity analysis for practical work. The methods are used in an examination of the size distribution of cities and firms.
Objectives:
To evaluate the clinical and economic burden of head and neck squamous cell carcinoma (HNSCC) in France.
Methods:
All 53,255 incident adult patients discharged with a first diagnosis of HNSCC in 2010–2012 were identified from the 2008–2013 French National Hospital Discharge (PMSI) database. We conducted a retrospective longitudinal analysis of prognosis and direct costs attributable to HNSCC.
Results:
Direct medical costs attributable to HNSCC care amounted to 665 million euros in 2012 in France. The majority (62%) of incident patients were 64 years old or less at HNSCC diagnosis and incurred 1.3-fold higher mean direct costs as compared to elderly patients (41,909 vs 32,221 euros over 3 years, respectively; p<0.001). HNSCC stage at initial treatment was the major driver of mean (SD) direct costs over 3 years (p<0.001): 19,819 (23,150) euros in 31% patients diagnosed at early stage; 46,791 (34,841) euros in 60% patients diagnosed at locally advanced stage; and 43,377 (33,953) euros in 9% patients diagnosed with distant metastasis. About half patients died over 3 years at a median (IQR) age of 63 (56–75) years resulting in 10.9 years-of-life lost on average per incident patient.
Conclusion:
The present study suggests that the clinical and economic burden of HNSCC is substantial in France.
Background :
Health state utility (HSU) is a core component of QALYs and cost-effectiveness analysis, although HSU is rarely estimated among a representative sample of patients. We explored the feasibility of assessing HSU in head and neck cancer from the French National Hospital Discharge database.
Methods:
An exhaustive sample of 53,258 incident adult patients with a first diagnosis of head and neck cancer was identified in 2010–2012. We used a cross-sectional approach to define five health states over two periods: three "cancer stages at initial treatment" (early, locally advanced or metastatic stage); a "relapse state" and otherwise a "relapse-free state" in the follow-up of patients initially treated at early or locally advanced stage. In patients admitted in post-acute care, a two-parameter graded response model (Item Response Theory) was estimated from all 144,012 records of six Activities of Daily Living (ADLs) and the latent health state scale underlying ADLs was calibrated with the French EQ-5D-3 L social value set. Following linear interpolation between all assessments of the patient, daily estimates of utility in post-acute care were averaged by health state, patient and month of follow-up. Finally, HSU was estimated by health state and month of follow-up for the whole patient population after controlling for survivorship and selection in post-acute care.
Results:
Head and neck cancer was generally associated with poor HSU estimates in a real-life setting. As compared to “distant metastasis at initial treatment”, mean HSU was higher in other health states, although numerical differences were small (0.45 versus around 0.54). It was primarily explained by the negative effects on HSU of an older age (38.4% aged ≥70 years in “early stage at initial treatment”) and comorbidities (> 50% in other health states). HSU estimates significantly improved over time in the “relapse-free state” (from 8 to 12 months of follow-up).
Conclusions:
HSU estimates in head and neck cancer were primarily driven by age at diagnosis, comorbidities, and time to assessment of cancer survivors. This feasibility study highlights the potential of estimating HSU within and across severe conditions in a systematic way at the national level.
This study assesses the impact of a tax incentive scheme to boost private rental investment in force in France from 2009 to 2012, called the “Scellier scheme” (after the name of the minister who promoted it), on changes in the price of building land. A difference in differences estimation is implemented, drawing on data from the BNDP database covering the period 2004 2010. The definition of the control and treatment groups is based on the boundary between municipalities which are eligible for the Scellier scheme and municipalities which are not. The estimation results suggest that the scheme had an inflationary effect and point to land price capitalisation, with an increase in the price per square metre of around 7 euros in the first year and of 8 to 9 euros over 2009 and 2010, without a significant rise of the phenome¬non in the second year, i.e. an increase of 8% in the first year and of 9 to 10% after two years. The regions where the market was the tightest saw the most rapid price increase, particularly the Mediterranean region.
La France se distingue par un nombre et un niveau élevé d’impôts sur la production. Ceux-ci peuvent être particulièrement nocifs en raison des distorsions qu’ils engendrent tout au long de la chaine de production : ils affectent directement les décisions des entreprises en termes de choix des modes de production et de prix et peuvent donc pénaliser leur productivité et leur compétitivité. En outre, ils augmentent le point mort des entreprises et peuvent expliquer, avec d’autres facteurs, la relative atrophie du secteur productif français. Dans cette nouvelle Note du CAE, Philippe Martin et Alain Trannoy examinent trois impôts sur la production parmi les plus importants et recommandent, en s’appuyant sur des travaux empiriques, de supprimer en priorité la C3S dont la nocivité n’a pas d’égal dans notre système fiscal, puis de s’attaquer à la CVAE. Cette stratégie de réforme et simplification de la fiscalité des entreprises pourrait s’accompagner, si les marges financières ne sont pas suffisantes, par des mesures visant à obtenir des recettes publiques de substitution moins nocives.
This paper provides a new mechanism to explain variation in firm productivity across locations: variation in the internal organization of labor into hierarchical layers, which are associated with different responsibilities within the firm. To guide my analysis, I develop a theoretical model that yields two implications. First, firms in larger markets organize into a greater number of layers. Second, because they have more layers, firms in larger markets are more productive. I then use administrative data to examine the model’s implications across French employment areas and non-tradeable service industries that satisfy the model’s assumptions: Clothing and Shoe Retail, Traditional Restaurants, and Hair and Beauty Salons. The findings are consistent with the model. I also observe that 8.8% to 22.4% of the log productivity gains from denser areas arise from differences in the organization of firms. A separate analysis shows that results are similar across firms operating in the manufacturing sector.
Dans cet article, nous construisons une base de données prosopographique de 476 savants et érudits ayant participé à l’enseignement à Aix-en-Provence sous l’Ancien régime. Nous couvrons ainsi l’ancienne université d’Aix (1409-1793), les écoles qui l’ont précédée (-1409) et le collège Royal Bourbon (1603-1763). L’analyse des données récoltées permet d’appréhender la démographie de cette population (longévité, mobilité). En outre, l’analyse de la notoriété de ces personnes met en avant un âge d’or au début du XVIIème siècle avec Pierre Gassendi, Charles-Hannibal Fabrot, et, au travers d’un lien plus lâche avec l’université, Nicolas Fabri de Peiresc. Nous montrons aussi l’absence d’un déclin franc en termes notoriété dans la période subséquente (1650-1793). Ce résultat contredit partiellement la vision selon laquelle les universités étaient devenues caduques à la fin de la période moderne, et souligne l’importance de s’intéresser au corps professoral des anciennes universités.
In the aftermath of the U.S. financial crisis, both a sharp drop in employment and a surge in corporate cash have been observed. In this paper, based on U.S. data, we argue that the negative relationship between the corporate cash ratio and employment is systematic, both over time and across firms. We develop a dynamic general equilibrium model where heterogenous firms need cash and external liquid funds in their production process. We analyze the dynamic impact of aggregate shocks and the cross-firm impact of idiosyncratic shocks. We show that external liquidity shocks generate a negative comovement between the cash ratio and employment, as documented in the data.
After‐tax income inequality has risen since the mid‐1990s, as increases in market income inequality have not been offset by greater fiscal redistribution. We argue that the substantial increase in the diversity of consumer goods has mitigated mounting political pressures for redistribution. Within a probabilistic voting framework, we demonstrate that if the share of diversified goods in the consumption bundle increases sufficiently with income, then an increase in goods diversity can reduce the political equilibrium tax rate. Focusing on OECD countries, we find empirical support for both the model's micro‐political foundations and the implied relation between goods diversity and fiscal policy outcomes.
