Health expenditure and sick leave in France between 2009 and 2012.

Summary The objective of this thesis is to define the role of health care expenditures in the French health care system and, in particular, to identify the extent to which health care represents a cost or an investment. It is based on a study of the interdependencies between health care and sick leave for more than 100,000 employees monitored between 2009 and 2012. The results demonstrate the dual preventive and curative component of any care.Our first work consists in identifying the additional cost of care due to ill health, based on a model regressing the cost of care on the fact of having been absent in 2012: there is then a significant cost of this care assimilated to consumption.Based on a Poisson model with inflation of zeros, we then reflect on the determinants of sick leave, and in particular on the role of the sector of activity in a portfolio of private sector employees. It appears that while the difference in sick leave reflects working conditions, the disparity in duration is more akin to employment conditions and social climate.We also look at the preventive role of health care, since it significantly reduces the future number of days of sick leave, using a fish model on panel data that takes into account the problem of initial condition.Our final classification of health care utilization and sick leave behavior shows health capital as a continuum in which investments are made.