3 QUESTIONS TO... : NOVEMBER 2015

1/ You are appointed Director of IRDES following its transformation into a public interest group (GIP). Did this transformation generate changes?

In a context of strong pressure on public expenditure, this transformation of Irdes into a Public Interest Group (GIP, groupement d'interêt public) aims to improve the institutions' coherence of action in terms of research and studies. The State as well as the Health Insurance Fund and the National Solidarity Fund for Autonomy (CNSA, Caisse nationale de solidarité pour l'autonomie) largely share these concerns. The transformation of IRDES – since its inception as an association under the French Law of 1901 – into a GIP has emerged as the best solution both in legal and technical terms to rationalize the use of public funds by pooling resources between different funders.
The GIP IRDES is a continuation of the association. This continuity is illustrated by the name of the organization that remains unchanged as well as its missions and its scope of action which, moreover, strengthen in the socio-medical field. This is a change in legal form that aims to secure the structure and missions. A scientific committee will continue to accompany IRDES as before.
This transformation allows our partners, who were not part of the association but regularly funded IRDES through operations and commissioned studies, to naturally enter governance. This is the case of the ministry of Health's Directorate of Research, Study, Evaluation and Statistics (DREES) and the CNSA. Members of the GIP will therefore be able to rely on IRDES for carrying out work as part of the Administrative Board of the Institute, which reviews and approves the multiannual work program.

2/ What is your professional background?

After my PhD in economics from the University of Toulouse in 2001, I joined the ministry of Health's Directorate of Research, Study, Evaluation and Statistics (DREES) which had been created by Mireille Elbaum. I started as a research fellow, and notably conducted work on the determinants of access to healthcare that helped to assess the Universal Health Coverage scheme (CMU). I was also responsible for building what is now the DREES annual survey on complementary insurance organizations. The successive Directors of DREES, Anne-Marie Brocas and Frank Von Lennep, then gave me increasing responsibilities that led me, among other things, to work on the link between compulsory and complementary health insurance or on the effect of the activity-based funding (T2A) in hospital care.
This professional path allowed me to work with various departments of the Ministry and the inspection bodies [Inspection Générale des Affaires Sociales-IGAS (French Government audit, evaluation and inspection office for health, social security and employment), Cour des Comptes (supreme body in charge of auditing the use of public funds in France)] and with professional organizations (federations representing complementary insurance providers, health institutions... ) while keeping a strong link with research, especially with IRDES, with which I collaborate continuously from the time I was a young doctoral student.
I was thus able to conduct studies aimed at different recipients: decision-support studies for ministry departments or cabinets, studies published by DREES and covered by the general or specialised press, and scientific articles published in academic journals, which give the overall work a scientific quality label.

3/ What are your projects for IRDES?

I want to emphasize our position in terms of applied research in health and medico-social areas in order to make the connection between research and decision support. To do this, it is not only necessary to ensure the quality of studies through regular scientific publications but also to ensure their greater visibility. This implies, firstly, to keep close ties with academic research, to rely on our Scientific Committee, and secondly, to ensure that each of our studies will be published in our monthly publication Issues in Health Economics, which is the proper format to reach decision makers and professionals.
The entrance of the CNSA will allow us to develop in the long term our studies in the field of disability and dependence. Thus, we are already working on the construction of a survey among beneficiaries of a disability compensation scheme. Concerning dependency, we work on the matching of CARE survey with data from the Health insurance, and we will naturally exploit the data. The development of our skills on the medico-social field leads us logically to be a partner of public statistics surveys in this field.
In the fields of healthcare and organization of care, the IRDES' work is an important reference. It is therefore crucial to continue on this path, while adapting to changing databases, including with the creation of the National Health Data System (SNDS, Système national de données de santé) laid down by the Health Law. Thus, we must intensify our expertise on medico-administrative databases. This will allow us to conduct more studies on care pathways.
Many studies on the subject are already planned (psychiatry, brain stroke) through experimentation assessments (senior healthcare pathways - PAERPA, people with chronic renal failure). Finally, we prepare several surveys in partnership with DREES: one on company supplementary social protection that will take place in 2017 and will help to assess the National interprofessionnal Agreement (Ani, Accord national interprofessionnel) generalizing the employer-mandated complementary health insurance, and in the longer term, the next European Health Interview Survey (EHIS) which will take place in 2019.

Interview by Anne Evans

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