Joël M-E. (2012), Dépendance : au-delà des coûts, Projet, 1, 326, p. 27-35
Nous devons, certes, trouver une façon pérenne de financer la perte d'autonomie d'un nombre croissant de personnes âgées. Mais au-delà de la question économique, la dépendance doit être envisagée de manière collective, car elle questionne notre conception de la famille, de la solidarité ou de la ville.
Dufour-Kippelen S., Joël M-E. (2011), Dépendance et soins de long terme en France, Papeles de economía española, 129, p. 137-148
This article deals with the supply and fi nuancing of long-term care in France for people aged 60 and more. Since the beginning of the 21st century substantial progress has been made in the institutional design of dependency coverage as well as in the development of specific programmes and benefi ts, but problems of effi cacy and coordination are evident. However, the main concern lies in the foreseeable rise of expenditure devoted to the coverage of dependency as a consequence of population ageing. Although the personalized compensation for autonomy is considered as a universal right, in the context of economic crisis and the need of fiscal discipline the maintenance of the family's main role in long-term care and the development of the private dependency insurance market seem likely.
Joël M-E. (2011), La prise en charge des personnes handicapées, Regards sur l'actualité, 372, p. 52-65
Joël M-E. (2010), Le " cinquième risque " : le défi du financement, Les Cahiers Français, 358, p. 83-89
Bodeau-Livinec F., Simon E., Montagnier-Petrissans C., Joël M-E., Féry-Lemonnier E. (2006), Impact of CEDIT recommendations: An example of health technology assessment in a hospital network, International Journal of Technology Assessment in Health Care, 22, 2, p. 161-168
Objectives: The objective of this study is to assess the impact of CEDIT (French Committee for the Assessment and Dissemination of Technological Innovations) recommendations on the introduction of technological innovations within the AP-HP (Assistance Publique-Hôpitaux de Paris), the French hospital network to which this body is attached. Methods: In 2002, a study based on semidirective interviews of fourteen people affected by these recommendations and a case study relating to thirteen recommendations issued between 1995 and 1998 were conducted. Results: The CEDIT is very scientifically reputable among interviewees. There is generally widespread interest for the recommendations. They are used as decision-making tools by administrative staff and as negotiating instruments by doctors in their dealings with management. Based on the case study, ten of thirteen recommendations had an impact on the introduction of the technology in health establishments. One recommendation appears not to have had an impact. Furthermore, the impact of two technologies was impossible to assess. Conclusions: This study highlights the significant impact of recommendations arising from a structure that is attached to a hospital network and the good match between CEDIT's objectives and its assignments.
Royer A-C., Ponton-Sanchez A., Joël M-E., Colvez A. (2002), Health status and work burden of Alzheimer patients' informal caregivers: Comparisons of five different care programs in the European Union, Health Policy, 60, 3, p. 219-233
Background: In 1998, a research study was conducted to compare existing programs in the European Union providing both care to people with senile dementia of the Alzheimer type, and support to their informal caregiver. Method: Five programs were selected in seven centres. Home social services (Denmark), Day centres (Germany), Expert Centres (Belgium, Spain), Group Living/Cantou (Sweden, France), Respite hospitalization (France). In each centre, 50 patients were randomly selected. The questionnaire addressed informal caregivers (or referents). It included the Nottingham Health Profile (NHP), the Zarit Scale, and it collected data on age, sex and position (spouse or child) of the informal caregiver, as well as age, level of mental deterioration and disabilities of the patient. Results: (n=322 subjects) Comparatively with caregivers of Respite hospitalization patients chosen as the reference, caregivers of patients cared by Group living/Cantou and Home social services experienced a significantly lower burden. The benefit from the Expert centre program concerned emotional reactions (depression) (odds ratio=0.32; P=0.02) and work burden (Zarit) (OR=0.32; P=0.04). The main benefit for caregivers who received Day centre help was the important reduction of feelings of social isolation (OR=0.13; P=0.0003). Conclusions: The Group Living/Cantou program appeared as the most efficient way to reduce informal caregiver burden, independently from the country considered.
Colvez A., Cozette E., Gramain A., Joël M-E. (2000), Economic Situation and the Quality of Life of the Informal Caregivers of Demented Elderly, Revue économique, 51, numÃ©ro spÃ©cial, p. 163-184
L'article présente les résultats d'une enquête financée par la Commission européenne portant sur la situation économique et la qualité de vie des aidants informels de personnes âgées atteintes de démence sénile. L'enquête porte sur 272 aidants inclus dans six programmes de soins innovants qui intègrent l'aidant. Les données originales recueillies décrivent la production d'aide, le coût de la prise en charge et son financement ainsi que l'impact des programmes de prise en charge sur la qualité de vie de l'aidant. Deux modèles économétriques spécifient les déterminants du temps d'aide et de la dépense de prise en charge effectuée par l'aidant et confirment l'existence d'une rationalité économique dans les comportements d'aide.
This article presents the results of an inquiry financed by the European Commission focused on the economic situation and the quality of life of the informal caregivers of demented elderly. The inquiry integrates 272 caregivers participating to six innovating care programs which include the caregivers. The original data describes the production of care, the cost and the financing of care, and the impact of professional care on the caregivers' quality of life. Two econometric models specify the determinants of care time and expenditures made by the caregiver and confirm the existence of an economic rationality in the care behavior.
Joël M-E. (1997), Mesure et normalisation : le cas de la dépendance des personnes âgées, in Kessler F. (dir.), La dépendance des personnes âgées, Paris, Sirey, p. 25-34
Joël M-E., Sibille R. (2013), Education and career path of French nursing home managers : impact on their human resources practices, TEPP Conference "Research in Health and Labour", Le Mans, France
In France, more than 75% of the establishments spec ialized in the care for dependant elderly people are EHPADs (Establishments with housing for dependa nt and elderly people). These structures were created with the aim to rationalize the offer in this sector, but remain economically inefficient. Besides the fact that private and for-profit EHPADs would be more efficient, the studies devoted to the efficiency of these nursing homes do not allow to comprehend the actual causes explaining this situation. Throughout this article, we attempt to open the EHPAD's black box in order to identify the differences in the production's organization from which the inefficiencies could originate. We hypothesize that EHPAD managers have different pref erences, correlated with their professional characteristics, which would explain their managing strategies, especially concerning human resources. The results of an original survey among a sample of EHPAD managers focused on management practice matched to the EHPA2011 survey were mobilized in the testing of this relation. It first appears that the directors adopt different strategies to optimize the management of their hum an resources. Three decisive points concerning the pol icy for optimizing personnel management were studied: organizing the nurses' timetables in ten-hour days versus maintaining a traditional organization in 7-hour days, introducing a regular attendance bonus versus not integrating this bonus in the form of remuneration, proposing diploma courses versus only offering short training courses. Probit models were used to explain the existence of different behaviors. In all three cases, the choices are determined by the managers' professional characteristics, notably their training. These results open up new perspectives for public authorities to improve the efficiency of EHPADs and the quality of the service they have to offer.
Joël M-E., Colvez A., Cozette E., Gramain A. (1999), Coût de la maladie d'Alzheimer et dépenses des aidants dans différents programmes de soins aux patients atteints de démence en Europe, XIXe journées de l'Association d'Economie Sociale, Paris, France
Cette communication présente la problématique et les résultats d'une étude européenne conduite sur la maladie d'Alzheimer dans huit pays de la Communauté en 1997 et 1998. L'objectif de cette étude était de produire des éléments de comparaison et d'évaluation des différents programmes européens de soins aux patients atteints de cette maladie et à leurs aidants.
Colvez A., Cozette E., Joël M-E., Gramain A. (1999), Analyse économique de la situation des aidants aux personnes âgées atteintes de démence, 7ème conférence internationale sur la science des systèmes dans le domaine des services socio-sanitaires pour les personnes âgées et les handicapés, Grenoble, France
Joël M-E. (1992), Pour un arbitrage entre efficience et équité. L'exemple de la politique française en faveur des personnes dépendantes, Colloque européen : "De l'analyse économique auxpolitiques de santé", Paris, France