Ventelou

Publications

Stated preferences outperform elicited preferences for predicting reported compliance with COVID-19 prophylactic measuresJournal articleIsmael Rafai, Thierry Blayac, Dimitri Dubois, Sebastien Duchêne, Phu Nguyen-Van, Bruno Ventelou et Marc Willinger, Journal of Behavioral and Experimental Economics, Volume 107, pp. 102089, 2023

This article studies the behavioral and socio-demographic determinants of reported compliance with prophylactic measures against COVID-19: barrier gestures, lockdown restrictions and mask wearing. The study contrasts two types of measures for behavioral determinants: experimentally elicited preferences (risk tolerance, time preferences, social value orientation and cooperativeness) and stated preferences (risk tolerance, time preferences, and the GSS trust question). Data were collected from a representative sample of the inland French adult population (N=1154) surveyed during the first lockdown in May 2020, and the experimental tasks were carried out on-line. The in-sample and out-of-sample predictive power of several regression models - which vary in the set of variables that they include - are studied and compared. Overall, we find that stated preferences are better predictors of compliance with these prophylactic measures than preferences elicited through incentivized experiments: self-reported level of risk, patience and trust are predicting compliance, while elicited measures of risk-aversion, patience, cooperation and prosociality did not.

Stated preferences outperform elicited preferences for predicting reported compliance with Covid-19 prophylactic measuresJournal articleIsmael Rafai, Thierry Blayac, Dimitri Dubois, Sebastien Duchêne, Phu Nguyen-Van, Bruno Ventelou et Marc Willinger, Journal of Behavioral and Experimental Economics, Volume 107, pp. 102089, 2023

This article studies the behavioral and socio-demographic determinants of reported compliance with prophylactic measures against COVID-19: barrier gestures, lockdown restrictions and mask wearing. The study contrasts two types of measures for behavioral determinants: experimentally elicited preferences (risk tolerance, time preferences, social value orientation and cooperativeness) and stated preferences (risk tolerance, time preferences, and the GSS trust question). Data were collected from a representative sample of the inland French adult population (N=1154) surveyed during the first lockdown in May 2020, and the experimental tasks were carried out on-line. The in-sample and out-of-sample predictive power of several regression models - which vary in the set of variables that they include - are studied and compared. Overall, we find that stated preferences are better predictors of compliance with these prophylactic measures than preferences elicited through incentivized experiments: self-reported level of risk, patience and trust are predicting compliance, while elicited measures of risk-aversion, patience, cooperation and prosociality did not.

Mandatory membership of community-based mutual health insurance in Senegal: A national surveyJournal articleValéry Ridde, Ibrahima Gaye, Bruno Ventelou, Elisabeth Paul et Adama Faye, PLOS Global Public Health, Volume 3, Issue 9, pp. e0001859, 2023

With the low adherence to voluntary mutual health insurance, Senegal’s policymakers have sought to understand the feasibility of compulsory health insurance membership. This study aims to measure the acceptability of mandatory membership in community-based mutual health insurance (CBHI) and to understand its possible administrative modalities. The study consists of a national survey among a representative population sample selected by marginal quotas. The survey was conducted in 2022 over the phone, with a random composition method involving 914 people. The questionnaire measured the socio-economic characteristics of households, their level of acceptability concerning voluntary and compulsory membership, and their level of confidence in CBHIs and the health system. Respondents preferred voluntary (86%) over mandatory (70%) membership of a CBHI. The gap between voluntary and compulsory membership scores was smaller among women (p = 0.040), people under 35 (p = 0.033), and people with no health coverage (p = 0.011). Voluntary or compulsory membership was correlated (p = 0.000) to trust in current CBHIs and health systems. Lack of trust in the CBHI management has been more disadvantageous for acceptance of the mandatory than the voluntary membership. No particular preference emerged as the preferred administrative channel (e.g. death certificate, identity card, etc.) to enforce the mandatory option. The results confirmed the well-known challenges of building universal health coverage based on CBHIs—a poorly appreciated model whose low performance reduces the acceptability of populations to adhere to it, whether voluntary or mandatory. Suppose Senegal persists in its health insurance approach. In that case, it will be essential to strengthen the performance and funding of CBHIs, and to gain population trust to enable a mandatory or more systemic membership.

Respective healthcare system performances taking into account environmental quality: what are the re-rankings for OECD countries?Journal articleArmel Ngami et Bruno Ventelou, Health Research Policy and Systems, Volume 21, Issue 1, pp. 57, 2023

Efficiency analyses have been widely used in the literature to rank countries regarding their health system performances. However, little place has been given to the environmental aspect: two countries with the same characteristics could experience completely different healthcare system outcomes just because they do not face the same environmental quality situation, which is a major determinant of the health of inhabitants.

United, can we be stronger? Did French general practitioners in multi-professional groups provide more chronic care follow-up during lockdown?Journal articleAnna Zaytseva, Pierre Verger et Bruno Ventelou, BMC Health Services Research, Volume 22, Issue 1, pp. 519, 2022

Background:
Given the importance of the continuous follow-up of chronic patients, we evaluated the performance of French private practice general practitioners (GPs) practicing in multi-professional group practices (MGP) regarding chronic care management during the first Covid-19 lockdown in Spring 2020 compared to GPs not in MGP. We consider two outcomes: continuity of care provision for chronic patients and proactivity in contacting these patients.
Methods:
The cross-sectional web questionnaire of 1191 GPs took place in April 2020. We exploit self-reported data on: 1) the frequency of consultations for chronic patients during lockdown compared to their "typical" week before the pandemic, along with 2) GPs' proactive behaviour when contacting their chronic patients. We use probit and bivariate probit models (adjusted for endogeneity of choice of engagement in MGP) to test whether GPs in MGP had significantly different responses to the Covid-19 crisis compared to those practicing outside MGP.
Results:
Out of 1191 participants (response rate: 43.1%), around 40% of GPs were female and 34% were younger than 50 years old. Regression results indicate that GPs in MGP were less likely to experience a drop in consultations related to complications of chronic diseases (- 45.3%). They were also more proactive (+ 13.4%) in contacting their chronic patients compared to their peers practicing outside MGP.
Conclusion:
We demonstrate that the MGP organisational formula was beneficial to the follow-up of patients with chronic conditions during the lockdown; therefore, it appears beneficial to expand integrated practices, since they perform better when facing a major shock. Further research is needed to confirm the efficiency of these integrated practices outside the particular pandemic setup.

When the messenger is more important than the message: an experimental study of evidence use in francophone AfricaJournal articleAmandine Fillol, Esther McSween-Cadieux, Bruno Ventelou, Marie-Pier Larose, Ulrich Boris Ngue Kanguem, Kadidiatou Kadio, Christian Dagenais et Valéry Ridde, Health Research Policy and Systems, Volume 20, Issue 1, pp. 57, 2022

Background:
Epistemic injustices are increasingly decried in global health. This study aims to investigate whether the source of knowledge influences the perception of that knowledge and the willingness to use it in francophone African health policy-making context.
Methods:
The study followed a randomized experimental design in which participants were randomly assigned to one of seven policy briefs that were designed with the same scientific content but with different organizations presented as authors. Each organization was representative of financial, scientific or moral authority. For each type of authority, two organizations were proposed: one North American or European, and the other African.
Results:
The initial models showed that there was no significant association between the type of authority or the location of the authoring organization and the two outcomes (perceived quality and reported instrumental use). Stratified analyses highlighted that policy briefs signed by the African donor organization (financial authority) were perceived to be of higher quality than policy briefs signed by the North American/European donor organization. For both perceived quality and reported instrumental use, these analyses found that policy briefs signed by the African university (scientific authority) were associated with lower scores than policy briefs signed by the North American/European university.
Conclusions:
The results confirm the significant influence of sources on perceived global health knowledge and the intersectionality of sources of influence. This analysis allows us to learn more about organizations in global health leadership, and to reflect on the implications for knowledge translation practices.

What drives the acceptability of restrictive health policies: An experimental assessment of individual preferences for anti-COVID 19 strategiesJournal articleThierry Blayac, Dimitri Dubois, Sebastien Duchêne, Phu Nguyen-Van, Bruno Ventelou et Marc Willinger, Economic Modelling, Volume 116, pp. 106047, 2022

The public acceptability of a policy is an important issue in democracies, in particular for anti-COVID-19 policies, which require the adherence of the population to be applicable and efficient. Discrete choice experiment (DCE) can help elicit preference ranking among various policies for the whole population and subgroups. Using a representative sample of the French population, we apply DCE methods to assess the acceptability of various anti-COVID-19 measures, separately and as a package. Owing to the methods, we determine the extent to which acceptability depends on personal characteristics: political orientation, health vulnerability, or age. The young population differs in terms of policy preferences and their claim for monetary compensation, suggesting a tailored policy for them. The paper provides key methodological tools based on microeconomic evaluation of individuals’ preferences for improving the design of public health policies.

Individuals’ willingness to provide geospatial global positioning system (GPS) data from their smartphone during the COVID-19 pandemicJournal articleYulin Hswen, Ulrich Nguemdjo, Elad Yom-Tov, Gregory M. Marcus et Bruno Ventelou, Humanities and Social Sciences Communications, Volume 9, Issue 1, pp. 336, 2022

This study aims to evaluate people’s willingness to provide their geospatial global positioning system (GPS) data from their smartphones during the COVID-19 pandemic. Based on the self-determination theory, the addition of monetary incentives to encourage data provision may have an adverse effect on spontaneous donation. Therefore, we tested if a crowding-out effect exists between financial and altruistic motivations. Participants were randomized to different frames of motivational messages regarding the provision of their GPS data based on (1) self-interest, (2) pro-social benefit, and (3) monetary compensation. We also sought to examine the use of a negative versus positive valence in the framing of the different armed messages. 1055 participants were recruited from 41 countries with a mean age of 34 years on Amazon Mechanical Turk (MTurk), an online crowdsourcing platform. Participants living in India or in Brazil were more willing to provide their GPS data compared to those living in the United States. No significant differences were seen between positive and negative valence framing messages. Monetary incentives of $5 significantly increased participants’ willingness to provide GPS data. Half of the participants in the self-interest and pro-social arms agreed to provide their GPS data and almost two-thirds of participants were willing to provide their data in exchange for $5. If participants refused the first framing proposal, they were followed up with a “Vickrey auction” (a sealed-bid second-priced auction, SPSBA). An average of $17 bid was accepted in the self-interest condition to provide their GPS data, and the average “bid” of $21 was for the pro-social benefit experimental condition. These results revealed that a crowding-out effect between intrinsic and extrinsic motivations did not take place in our sample of internet users. Framing and incentivization can be used in combination to influence the acquisition of private GPS smartphone data. Financial incentives can increase data provision to a greater degree with no losses on these intrinsic motivations, to fight the COVID-19 pandemic.

Do efficiency and equity move together? Cross-dynamics of Health System performance and Universal Health CoverageJournal articlePavitra Paul, Ulrich Nguemdjo, Armel Ngami, Natalia Kovtun et Bruno Ventelou, Humanities and Social Sciences Communications, Volume 9, Issue 1, pp. 1-8,Art.nr:293, 2022

Efficiency within the health system is well recognised as key for achieving Universal Health Coverage (UHC). However, achieving equity and efficiency simultaneously is often seen as a conflicting effort. Using 12 years of data (2003–2014) from the selection of a number of low- and lower middle-income countries (Afghanistan, Bangladesh, Burkina Faso, Ghana, Indonesia, Mongolia, Mozambique, Tajikistan, Togo, Uzbekistan and Yemen Republic), we compute an index of Universal health coverage (UHC), measure the health system’s performance (HSp) and, finally, investigate the cross-dynamics of the resulting HSp and the UHC previously obtained. We find that, with the few exceptions over the statistical sample, the causality between performances of the national health system and the universal health coverage is typically bidirectional. From an empirical standpoint, our findings challenge the idea from economic orthodoxy that efficiency must precede equity in healthcare services. Rather, our findings support the view of simultaneous efforts to improve expansion of the coverage and efficiency of the health system, directing attention towards the importance of organisation of the health system in the country context.

Quand le messager est plus important que le message : étude expérimentale en Afrique francophone sur l’utilisation des connaissancesJournal articleAmandine Fillol, Esther Mc Sween-Cadieux, Bruno Ventelou, Marie-Pier Larose, Ulrich Nguemdjo, Kadidiatou Kadio, Christian Dagenais et Valéry Ridde, Revue francophone de recherche sur le transfert et l’utilisation des connaissances, Volume 6, Issue 3, 2022

Contexte : Les injustices épistémiques sont de plus en plus décriées dans le domaine de la santé mondiale. Cette étude vise à déterminer si la source des connaissances influence la perception de ces connaissances et la volonté de les utiliser.
Méthodes : L’étude suit un devis expérimental randomisé dans lequel les participant·es ont été assigné·es au hasard à l'une des sept notes de politique conçues avec le même contenu scientifique, mais avec différentes organisations présentées comme autrices. Chaque organisation était représentative d'une autorité financière, scientifique ou morale. Pour chaque type d'autorité, deux organisations étaient proposées : l'une nord-américaine ou européenne, l'autre africaine.
Résultats : Les résultats montrent que le type d’autorité et la localisation des organisations autrices ne sont pas significativement associés à la qualité perçue et à l’utilisation instrumentale déclarée. Toutefois, des interactions entre le type d’autorité et la localisation étaient significatives. Ainsi, les analyses stratifiées ont mis en évidence que pour la qualité perçue, les notes de politique signées par l'organisme bailleur (autorité financière) africain obtenaient de meilleurs scores que les notes de politique signées par l’organisme bailleur nord-américain/européen. Tant pour la qualité perçue que pour l'utilisation instrumentale déclarée, ces analyses stratifiées ont révélé que les notes de politique signées par l'université africaine (autorité scientifique) étaient associées à des scores plus faibles que les notes de politique signées par l'université nord-américaine/européenne.
Interprétation : Les résultats confirment l'influence significative des sources sur la perception des connaissances en santé mondiale et rappellent l’intersectionnalité de l’influence des sources d’autorité. Cette analyse nous permet à la fois d'en apprendre davantage sur les organisations qui dominent la scène de la gouvernance mondiale en santé et de réfléchir aux implications pour les pratiques d'application des connaissances.