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Les personnes dépendantes en France : Evolution et prise en charge
[Old-age disability in France: Long-term evolution, private caregiving and public expenditure]


  • Duée, Michel
  • Rebillard, Cyril
  • Pennec, Sophie


Using the microsimulation model Destinie, we project the number of elderly disabled people by 2040 in France. Transition probabilities between three different states of disability (non-dependent, moderately dependent, severely dependent) are estimated based on data from the HID survey, a two-wave panel. Results are very sensitive to our assumptions regarding the average duration of disability. In our central scenario, in which life expectancy with disability at age 60 remains stable, 1.2 million elderly people would suffer from disability in 2040, a 50% increase compared to 2000. The average age of the disabled elderly would increase markedly, from 78 to 82 years for men, and from 83 to 87.7 years for women. The share of severely dependent elderly people would remain stable, at 41% of the total number of disabled elderly. Microsimulation also allows for a longitudinal approach. We follow individuals from generations 1940 to 1954, from their 60th birthday to their death. Women are more affected by old-age disability than men: among the individuals living beyond age 60, 52% of women and 29% of men would experience at least one year in dependency. Because of the fall in fertility and the increasing number of divorces, the average number of potential caregivers (spouse and children) will tend to decrease over the next 40 years, from 2.8 to 2.3 for men and from 2.2 to 2.0 for women. The number of disabled people without spouse nor valid child would increase from 125,000 today to 165,000 in 2040. With unchanged legislation, the annual public expenditures related to Apa (Allocation personnalisée d’autonomie, the disability allowance targeted toward elderly people) would increase from 3.5 to 4 billion euros (in constant prices) in 2040. This moderate evolution is due to the assumption of a price-indexed schedule: the maximum value of the benefit would remain stable in constant prices, and the share of this maximum value actually paid to beneficiaries would decline over time. Indeed, this share depends on household resources; even though pensions are themselves price-indexed, their average level will increase significantly due to the renewal of cohorts of pensioners. Results are markedly different if we assume an indexation of Apa on wages. Such an assumption takes a better account of likely changes in costs of caregiving to disabled people: it would lead to an annual public cost of about 10.2 billion euros in 2040.

Suggested Citation

  • Duée, Michel & Rebillard, Cyril & Pennec, Sophie, 2005. "Les personnes dépendantes en France : Evolution et prise en charge [Old-age disability in France: Long-term evolution, private caregiving and public expenditure]," MPRA Paper 69877, University Library of Munich, Germany.
  • Handle: RePEc:pra:mprapa:69877

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    1. repec:cai:popine:popu_p2000_55n6_1034 is not listed on IDEAS
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    Cited by:

    1. Pierre Pestieau & Grégory Ponthière, 2010. "Long term care insurance puzzle," Working Papers halshs-00564862, HAL.
    2. Claire Marbot & Delphine Roy, 2015. "Projections du coût de l’APA et des caractéristiques de ses bénéficiaires à l’horizon 2040 à l’aide du modèle Destinie," Économie et Statistique, Programme National Persée, vol. 481(1), pages 185-209.
    3. Joëlle Gaymu & Peter Ekamper & Gijs Beets, 2007. "Qui prendra en charge les Européens âgés dépendants en 2030 ?," Population (french edition), Institut National d'Études Démographiques (INED), vol. 62(4), pages 789-822.
    4. CREMER, Helmuth & PESTIEAU, Pierre & PONTHIERE, Grégory, 2012. "The economics of long-term care: a survey," CORE Discussion Papers 2012030, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    5. Marie-Louise Leroux & Grégory Ponthière, 2009. "Wives, husbands and wheelchairs: Optimal tax policy under gender-specific health," PSE Working Papers halshs-00575059, HAL.
    6. repec:cai:poeine:pope_704_0675 is not listed on IDEAS

    More about this item


    Old-age disability; microsimulation; Destinie; Apa;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination


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