Cyclical behavior of hiring discrimination: evidence from repeated experiments in France.

Our objective is to investigate if hiring discrimination in France has a cyclical nature using an innovative set of repeated correspondence tests. The methodology covers one type of job only, that of administrative manager, in both the private and public sectors, and two discrimination criteria, ethnic origin and place of residence. The empirical analysis is based on five waves of tests starting in 2015, covering the periods before, during, and after the first lockdown, with 4749 applications sent for 1583 job openings in total. Our results indicate that hiring discrimination based on the dual criteria of origin and place of residence has decreased in France since the mid-2010s, within the context of an improved labor market, but that it increased sharply during the Covid health crisis, in recessionary conditions, suggesting that it generally follows a counter-cyclical behavior. Overall, the temporal patterns of discrimination, as measured by callback rates, mirror those of the unemployment rate.

Cream skimming and discrimination in access to medical care: A field experiment.

This study measures the differences in access to healthcare for female patients in France in three medical specialties (dentistry, gynecology and psychiatry) according to two criteria: the African ethnicity of the patient and the benefit of having means-tested health insurance coverage. To this purpose, we conducted a nationally representative field experiment on more than 1500 physicians. We do not find substantial discrimination against the patient of African origin. However, the results indicate that patients with means-tested health insurance coverage are less likely to get an appointment. Differentiating between two types of coverage, we show that the lesser-known coverage (ACS) is more penalized than the other (CMU-C) as poor knowledge of the program increases the physician's expectation of additional administrative tasks and is an important element to explain cream-skimming. We also find that, for physicians who are free to set their fees, the opportunity cost of accepting a means-tested patient increases the penalty. Finally, the results suggest that enrollment in OPTAM, the controlled pricing practice option that incentivizes physicians to accept means-tested patients, reduces cream-skimming.

Is disability more discriminatory in hiring than ethnicity, address or gender? Evidence from a multi-criteria correspondence experiment.

In this paper, we conduct a multi-criteria correspondence test to assess the extent of discrimination in access to employment against candidates with a hearing disability and compare it to three other potential grounds for discrimination: ethnicity, place of residence and gender. From October 2019 to February 2020, we sent 2315 applications to 463 job vacancies in the Paris region in France for two occupations, administrative managers and caregiver assistants, in both the private and public sectors. We find that discrimination on the grounds of disability is similar in scope to that found on the grounds of ethnicity in the profession of administrative manager, but discrimination against the disabled candidate is half that experienced by the North African candidate in the profession of caregiver assistant. Moreover, discrimination on the grounds of disability is twice as high in the profession of caregiver assistant, a role which requires more interaction with public, as in the profession of administrative manager. We do not find any evidence of a difference in callback rates based on place of residence or gender. Finally, we cannot conclude that hiring discrimination is systematically lower in the public sector than in the private sector, nor that being eligible for a public subsidy reduces hiring discrimination against the disabled candidate.

An evaluation of five regional health information technology-based programmes to improve health and social care coordination: A quasi-experimental controlled before/after mixed design.

OBJECTIVES: Health information technology (HIT) can help coordinate health and social actors involved in patients' pathways. We assess five regional HIT-based programmes ('Territoires de Soins Numériques' or TSN) introduced in France, covering the period 2012-2018. METHODS: This was a quasi-experimental controlled before/after mixed design. We used data from the French National Health Insurance database, qualitative and quantitative surveys, and information extracted from project documents and databases. We assessed the impact of TSN using four main impact indicators: emergency room visits, unplanned hospitalizations, avoidable hospitalizations and rehospitalization within 30 days. We also collected qualitative and secondary quantitative data covering perceived needs, knowledge, use, satisfaction, adoption and understanding of projects, pathway experience, impact on professional practices and appropriateness of hospitalizations. RESULTS: TSN implemented a heterogeneous mix of HIT. Implementation was slower than expected and was not well documented. Users perceived the HIT as having a positive but weak overall effect. There were no significant differences in trends for the main impact indicators, nor on the appropriateness of hospitalizations, but favourable trends on secondary polypharmacy indicators. CONCLUSIONS: If similar innovations take place in future, they should be based on a logical framework that defines causal, measurable links between services provided and expected impacts.