Decomposing the causes of health care use inequalities: a micro-simulations approach

This work analyzes health care consumption behaviors. We focus on their impact on health care distribution within the French population. We run analyses on individual data and make use of microsimulations in order to evaluate the effects of the heterogeneity of individual behaviors. We propose here an innovative method of the decomposition of health care use inequalities by factors. For a given morbidity, health care consumption is concentrated among the rich ; we show that half of this inequity is due to the heterogeneity of behaviors relative to the rank of individuals in the income distribution. This heterogeneity cannot be identified in the standard decompositions. We propose 3 applications of this method : a decomposition of inequality by factors for France, year 1998, the evaluation of the impact of CMU (universal free care) on the changes in health care use inequalities, and a comparison between the sources of inequality between elderly people (65+) and people aged 15 to 64.