Simon Combes | University College London (original) (raw)
Papers by Simon Combes
Applied Economics, Jul 9, 2018
HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific re... more HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires Hospital Staff Shortage: the Role of the Competitiveness of Pay of Different Groups of Nursing Staff on Staff Shortage. Shortages of nursing staff in OECD countries have been a preoccupation for policy makers. Shortages of staff may be the consequence of uncompetitive pay. In the private sector, employers in different regions can offer different pay rates to reflect local amenities and cost of living. Hospitals in the UK however cannot set the pay for their employees, and as a result they might therefore incur staff shortages. Moreover, occupational groups do not operate in isolation. Shortages of staff may also be the consequence of the competitiveness of pay of an alternative group of staff. This is investigated using two distinct groups of nursing staff: assistant nurses and registered nurses working in English hospitals in 2003-5 using national-level data-sets. We find that an increase by 10% of the pay competitiveness of registered nurses decreases the shortage of both the registered nurses and of assistant nurses by 0.6% and 0.4% respectively.
International audienceJ-B. Combes interroge la santé perçue, en tant qu’indicateur reconnu de mor... more International audienceJ-B. Combes interroge la santé perçue, en tant qu’indicateur reconnu de mortalité et de morbidité, chez des personnes migrantes. Les vécus et problématiques de santé de ces personnes restent souvent méconnus du fait d’un accès difficile à ces populations dans les enquêtes. J-B Combes s’est ainsi appuyé sur les données recueillies par l’ONG Médecins du Monde au sein de ses centres de santé en Europe. Les résultats de cette analyse seront mis en perspective avec les enjeux de l’enquête européenne en cours Mig-HealthCare, portant sur la réduction des inégalités en santé chez les personnes en situation de migration et de vulnérabilité
European Journal of Public Health, 2018
Delegating tasks to paramedics is a fairly recent development in France. So far it has essentiall... more Delegating tasks to paramedics is a fairly recent development in France. So far it has essentially been developed in hospitals and is incipient in general practice. This paper focuses on the willingness of general practitioner to do so. A 2012 survey of 2,000 GPs might help anticipate GPs' willingness to delegate. This paper tests whether a more favourable funding system might help increase GP willingness. We implement a quasi-experimental design wherein GPs are randomly selected to form three groups of equal size, each of them being exposed to a different funding scheme when declaring their willingness to delegate tasks to nurses: Fully Funded (FF) by the social security administration, self-funded by GPs' revenues (Self-Funded, SF) and half-funded by both the social security administration and GPs (Half-Funded, HF). GPs' likelihood to favour task delegation is estimated with a probit model that especially considers a GP's attitude towards risk (aversion or toleranc...
Social Psychiatry and Psychiatric Epidemiology, 2008
Little is known about the role of stressors associated with university life on psychological dist... more Little is known about the role of stressors associated with university life on psychological distress (PD). The aims of this article are to: (1) assess the prevalence of PD among students during their first year of university; (2) study its associations with stressors (socioeconomic and university-related) and protective factors (mastery, social support); and (3) to compare these factors according to gender. Methods Cross-sectional study of a random sample of students aged 18-24 years, in their first year of university in 2005-2006, enrolled in the 6 universities of southeastern France. Standardised questionnaire, by self-administration or telephone interview. Overall, 1,743 students agreed to participate (71.0%). Results PD prevalence was estimated at 15.7% (95% CI: 12.9-18.5) among the young men and 33.0% (95% CI: 30.2-35.9) among the young women. Multiple logistic regressions adjusted for social and demographic variables, mode of questionnaire administration, psychiatric history, and recent adverse life events, showed that among men PD was associated with lack of adjustment to the university academic environment (OR = 1.08; 95% CI: 1.00-1.17, P = 0.04), and mastery (OR = 0.73; 95% CI: 0.68-0.79). Among women, the prevalence of PD was associated with medical studies (OR = 2.46; 95% CI: 1.50-4.05), lack of adjustment to the university academic environment (OR = 1.07; 95% CI: 1.03-1.12), mastery (OR = 0.78; 95% CI: 0.75-0.82), and social support (OR = 0.68; 95% CI: 0.54-0.85), with a strong negative statistical interaction between mastery and lack of adjustment. Conclusions This study shows an intermediate prevalence of PD among French first-year university students compared with those observed in university students in other countries. It suggests that PD is related to university-related stressors but failed to find a relation to socioeconomic factors. Risk and protective factors for PD in first-year university students differed somewhat according to gender. However, mastery appeared to have a protective role in both genders. Further research is necessary to confirm these results in other universities and years.
Sheffield, UK, 2009
Page 1. DRAFT Nursing Workforce Skill Mix and the Competiveness of Qualified Nurses Pay: a local ... more Page 1. DRAFT Nursing Workforce Skill Mix and the Competiveness of Qualified Nurses Pay: a local labour market analysis ∗Jean-Baptiste Combes, Bob Elliott and Diane Skåtun Health Economics Research Unit, University of Aberdeen, ABERDEEN AB25 2ZD Address for correspondence: Jean-Baptiste Combes, Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. Email: jeanbaptiste.combes@abdn.ac.uk 1 Page 2. 1. Introduction ...
International audienceWithin hospital settings, delegation to paramedics is fairly recent in Fran... more International audienceWithin hospital settings, delegation to paramedics is fairly recent in France. Whether General Practitioners are likely to follow hospital consultants is unknown. A 2012 survey of 2,000 GPs might help foresee GPs willingness to do so. This paper tests whether a more favourable funding system might help increasing GPs willingness. We implement a quasi-experimental design wherein GP’s are randomly selected to form three groups of equal size, each of them being exposed to a different funding scheme when declaring their willingness to delegate tasks to nurses: fully funded (FF) by the social security administration, self-funded by GPs’ revenues (Self Funded, SF) and half-funded by both the social security administration and GPs (Half Funded, HF). GP’s likelihood to be in favour of task delegation is estimated with a Probit model which especially considers GP’s attitude toward risk (aversion or preference), among a set of covariates such as age, gender, rural/urban ...
La santé des migrants en question(s), 2019
European Journal of Public Health, 2019
Background Under-aged migrants (UAMs) may see their legal minority unrecognised by the French sta... more Background Under-aged migrants (UAMs) may see their legal minority unrecognised by the French state. If they confront this decision at court, they stand in a legal void. They can benefit from a direct access to State Medical Aid and are not submitted to a minimum period of 3 months of staying in France unlike adults. Moreover, when accessing care, unrecognised UAMs are in an unclear situation as they are minors without legal representation. This research is based on a newly created program ran by Doctors of the World (MDM) in Nantes, aiming to enhance UAMs access to health care and rights through peer-support. Peer-support is intended to develop the empowerment the UAM and help them to be able to be the authors of their life thus develop their own abilities (Le Grand, 2018). The role of empowerment in health access is established (Wallerstein, 2006). The research aims at identifying the obstacles and levers in the implementation of the program, the modifications it can cause in the ...
Le droit universel aux soins est un droit etabli de longue date par les normes juridiques interna... more Le droit universel aux soins est un droit etabli de longue date par les normes juridiques internationales. En 1946, la Constitution de l'Organisation mondiale de la sante (OMS) dispose que la sante « constitue l'un des droits fondamentaux de tout etre humain, quelles que soient sa race, sa religion, ses opinions politiques, sa condition economique ou sociale ». En 1948, la Declaration universelle des droits de l'homme dans son article 25, alinea 1, precise que « toute personne a droit a un niveau de vie suffisant pour assurer sa sante, son bien-etre et ceux de sa famille […] elle a droit a la securite en cas de chomage, de maladie, d'invalidite, de veuvage, de vieillesse ou dans les autres cas de perte de subsistance par suite de circonstances independantes de sa volonte ». Cette meme annee, la France reconnait egalement ce droit a travers le 11eme alinea du preambule de la Constitution : « La nation garantit a tous et notamment a l'enfant, a la mere et aux vieux...
Applied Economics, Jul 9, 2018
HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific re... more HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires Hospital Staff Shortage: the Role of the Competitiveness of Pay of Different Groups of Nursing Staff on Staff Shortage. Shortages of nursing staff in OECD countries have been a preoccupation for policy makers. Shortages of staff may be the consequence of uncompetitive pay. In the private sector, employers in different regions can offer different pay rates to reflect local amenities and cost of living. Hospitals in the UK however cannot set the pay for their employees, and as a result they might therefore incur staff shortages. Moreover, occupational groups do not operate in isolation. Shortages of staff may also be the consequence of the competitiveness of pay of an alternative group of staff. This is investigated using two distinct groups of nursing staff: assistant nurses and registered nurses working in English hospitals in 2003-5 using national-level data-sets. We find that an increase by 10% of the pay competitiveness of registered nurses decreases the shortage of both the registered nurses and of assistant nurses by 0.6% and 0.4% respectively.
International audienceJ-B. Combes interroge la santé perçue, en tant qu’indicateur reconnu de mor... more International audienceJ-B. Combes interroge la santé perçue, en tant qu’indicateur reconnu de mortalité et de morbidité, chez des personnes migrantes. Les vécus et problématiques de santé de ces personnes restent souvent méconnus du fait d’un accès difficile à ces populations dans les enquêtes. J-B Combes s’est ainsi appuyé sur les données recueillies par l’ONG Médecins du Monde au sein de ses centres de santé en Europe. Les résultats de cette analyse seront mis en perspective avec les enjeux de l’enquête européenne en cours Mig-HealthCare, portant sur la réduction des inégalités en santé chez les personnes en situation de migration et de vulnérabilité
European Journal of Public Health, 2018
Delegating tasks to paramedics is a fairly recent development in France. So far it has essentiall... more Delegating tasks to paramedics is a fairly recent development in France. So far it has essentially been developed in hospitals and is incipient in general practice. This paper focuses on the willingness of general practitioner to do so. A 2012 survey of 2,000 GPs might help anticipate GPs' willingness to delegate. This paper tests whether a more favourable funding system might help increase GP willingness. We implement a quasi-experimental design wherein GPs are randomly selected to form three groups of equal size, each of them being exposed to a different funding scheme when declaring their willingness to delegate tasks to nurses: Fully Funded (FF) by the social security administration, self-funded by GPs' revenues (Self-Funded, SF) and half-funded by both the social security administration and GPs (Half-Funded, HF). GPs' likelihood to favour task delegation is estimated with a probit model that especially considers a GP's attitude towards risk (aversion or toleranc...
Social Psychiatry and Psychiatric Epidemiology, 2008
Little is known about the role of stressors associated with university life on psychological dist... more Little is known about the role of stressors associated with university life on psychological distress (PD). The aims of this article are to: (1) assess the prevalence of PD among students during their first year of university; (2) study its associations with stressors (socioeconomic and university-related) and protective factors (mastery, social support); and (3) to compare these factors according to gender. Methods Cross-sectional study of a random sample of students aged 18-24 years, in their first year of university in 2005-2006, enrolled in the 6 universities of southeastern France. Standardised questionnaire, by self-administration or telephone interview. Overall, 1,743 students agreed to participate (71.0%). Results PD prevalence was estimated at 15.7% (95% CI: 12.9-18.5) among the young men and 33.0% (95% CI: 30.2-35.9) among the young women. Multiple logistic regressions adjusted for social and demographic variables, mode of questionnaire administration, psychiatric history, and recent adverse life events, showed that among men PD was associated with lack of adjustment to the university academic environment (OR = 1.08; 95% CI: 1.00-1.17, P = 0.04), and mastery (OR = 0.73; 95% CI: 0.68-0.79). Among women, the prevalence of PD was associated with medical studies (OR = 2.46; 95% CI: 1.50-4.05), lack of adjustment to the university academic environment (OR = 1.07; 95% CI: 1.03-1.12), mastery (OR = 0.78; 95% CI: 0.75-0.82), and social support (OR = 0.68; 95% CI: 0.54-0.85), with a strong negative statistical interaction between mastery and lack of adjustment. Conclusions This study shows an intermediate prevalence of PD among French first-year university students compared with those observed in university students in other countries. It suggests that PD is related to university-related stressors but failed to find a relation to socioeconomic factors. Risk and protective factors for PD in first-year university students differed somewhat according to gender. However, mastery appeared to have a protective role in both genders. Further research is necessary to confirm these results in other universities and years.
Sheffield, UK, 2009
Page 1. DRAFT Nursing Workforce Skill Mix and the Competiveness of Qualified Nurses Pay: a local ... more Page 1. DRAFT Nursing Workforce Skill Mix and the Competiveness of Qualified Nurses Pay: a local labour market analysis ∗Jean-Baptiste Combes, Bob Elliott and Diane Skåtun Health Economics Research Unit, University of Aberdeen, ABERDEEN AB25 2ZD Address for correspondence: Jean-Baptiste Combes, Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. Email: jeanbaptiste.combes@abdn.ac.uk 1 Page 2. 1. Introduction ...
International audienceWithin hospital settings, delegation to paramedics is fairly recent in Fran... more International audienceWithin hospital settings, delegation to paramedics is fairly recent in France. Whether General Practitioners are likely to follow hospital consultants is unknown. A 2012 survey of 2,000 GPs might help foresee GPs willingness to do so. This paper tests whether a more favourable funding system might help increasing GPs willingness. We implement a quasi-experimental design wherein GP’s are randomly selected to form three groups of equal size, each of them being exposed to a different funding scheme when declaring their willingness to delegate tasks to nurses: fully funded (FF) by the social security administration, self-funded by GPs’ revenues (Self Funded, SF) and half-funded by both the social security administration and GPs (Half Funded, HF). GP’s likelihood to be in favour of task delegation is estimated with a Probit model which especially considers GP’s attitude toward risk (aversion or preference), among a set of covariates such as age, gender, rural/urban ...
La santé des migrants en question(s), 2019
European Journal of Public Health, 2019
Background Under-aged migrants (UAMs) may see their legal minority unrecognised by the French sta... more Background Under-aged migrants (UAMs) may see their legal minority unrecognised by the French state. If they confront this decision at court, they stand in a legal void. They can benefit from a direct access to State Medical Aid and are not submitted to a minimum period of 3 months of staying in France unlike adults. Moreover, when accessing care, unrecognised UAMs are in an unclear situation as they are minors without legal representation. This research is based on a newly created program ran by Doctors of the World (MDM) in Nantes, aiming to enhance UAMs access to health care and rights through peer-support. Peer-support is intended to develop the empowerment the UAM and help them to be able to be the authors of their life thus develop their own abilities (Le Grand, 2018). The role of empowerment in health access is established (Wallerstein, 2006). The research aims at identifying the obstacles and levers in the implementation of the program, the modifications it can cause in the ...
Le droit universel aux soins est un droit etabli de longue date par les normes juridiques interna... more Le droit universel aux soins est un droit etabli de longue date par les normes juridiques internationales. En 1946, la Constitution de l'Organisation mondiale de la sante (OMS) dispose que la sante « constitue l'un des droits fondamentaux de tout etre humain, quelles que soient sa race, sa religion, ses opinions politiques, sa condition economique ou sociale ». En 1948, la Declaration universelle des droits de l'homme dans son article 25, alinea 1, precise que « toute personne a droit a un niveau de vie suffisant pour assurer sa sante, son bien-etre et ceux de sa famille […] elle a droit a la securite en cas de chomage, de maladie, d'invalidite, de veuvage, de vieillesse ou dans les autres cas de perte de subsistance par suite de circonstances independantes de sa volonte ». Cette meme annee, la France reconnait egalement ce droit a travers le 11eme alinea du preambule de la Constitution : « La nation garantit a tous et notamment a l'enfant, a la mere et aux vieux...