Sick Leaves: Understanding Disparities Between French Departments

The purpose of this publication is to better understand disparities between the proportions of sick leaves granted among various departments in France. The Hygie database was used for this study. It was created by merging a number of administrative files of employees in the private sector in France in 2005. This database allows for the determination of «employer/employee» relations, the impact of the characteristics of firms on the health of their employees and the interactions between health and work. After briefly reviewing the various determinants for the effect of composition and the effect of context, as well as sick leaves and their importance for understanding geographic differences, we present a three-phase empirical analysis: a descriptive analysis to detect differences between departments, a multivariate analysis to highlight explanatory factors of probability of being on sick leave and, finally, an analysis of determinants of differences between departments. Our different models explain a significant portion of the disparities between departments. The effects of composition and effects of context account for approximately two-thirds of the mean squared error. The variables describing the medical supply (density of general practitioners), monitoring by National Health Insurance and patient age when the professional career began best explain the disparities between departments concerning sick leave. In contrast to other compositions or contexts included in our model, the percentage of sick leaves verified and the density of general practitioners are important factors with respect to health policies. Our research shows that they could be used as public policy instruments aimed at reducing geographic disparities.