Sick pay for medical disorders paid by the general scheme of French national health insurance: Inventory and determining factors

Sick pay expenditures for medical disorders increased substantially in 2002. This increase was probably related to the significant increase in long-term sick leave prescribed in 2001. Expenditures for these benefits slowed down in 2003 due to stabilization in short-term sick pay and a slower increase in long-term sick pay. A number of different factors have been described in the literature to explain individual prescriptions and/or the overall evolution in sick leave. In addition to the patient’s state of health, other determining factors influencing individual prescriptions seem to be related to specific characteristics of either the prescribing physicians (age, gender, patient load) or the patients (age, educational level, working conditions). Changes in the composition of the labor force, the present-day work market, economic growth or contemporary social policies have all been suggested as possible explanations for the overall evolution in sick leave benefits. In conclusion , considering the number of different determining factors responsible for the changes in sick pay benefits, an equally broad range of regulatory tools need to be put into place: actions aimed at controlling and punishing "abnormal" individual behavior or actions to alert, educate and better inform players who "are not aware" of the consequences of their behavior and finally, actions to incite employers to improve working conditions in general.