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Medical Spending in France: Concentration, Persistence and Evolution before Death


  • Christelle Gastaldi-Ménager
  • Pierre-Yves Geoffard

    (PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique)

  • Grégoire de Lagasnerie

    (OCDE - Organisation de Coopération et de Développement Economiques, PSE - Paris School of Economics)


This paper studies medical spending in France from three perspectives: concentration, persistence, and evolution before death. We use claims data from a representative sample of over 500,000 individuals covered by the National Health insurance scheme, from 2008 to 2013. These data contain individual-level information (gender, age, date of death), some clinical information and detailed information on each medical treatment (inpatient, outpatient, drugs). Medical spending in France is highly concentrated. In 2013, 10 per cent of the population accounted for 62 per cent of all health care spending. In addition, the concentration of medical expenditure increased between 2008 and 2013. The concentration of insurance reimbursement, however, is even greater, indicating that French social health insurance redistributes income from the healthy to the unhealthy. The serial correlation of health care expenditures appears relatively high between adjacent years, but not surprisingly decreases over time. Decedents have high medical expenditures – on average, eight times those of survivors – and resources devoted to health care in the last three years of life represent, on average, 22 per cent of lifetime medical spending. Decedents' expenditures decrease with age after 55 years old.

Suggested Citation

  • Christelle Gastaldi-Ménager & Pierre-Yves Geoffard & Grégoire de Lagasnerie, 2016. "Medical Spending in France: Concentration, Persistence and Evolution before Death," Post-Print halshs-01509725, HAL.
  • Handle: RePEc:hal:journl:halshs-01509725
    DOI: 10.1111/j.1475-5890.2016.12107
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