The Imaginary Healthy Patient

Our paper titled The Imaginary Healthy Patient, co-authored with Amady Seydou Ba, Pierre Michel and Alain Paraponaris, has been accepted for publication in the special issue on “Machine Learning and Economics” in Revue d’économie politique.

The working paper is available here: Working paper

At the beginning of this project, Amady Seydou Ba was involved in the NovaCare project at Progexia (a Health insurance agency in Marseille founded by Jean-Louis Lesieur). The NovaCare project was partially funded by Malakoff Humanis.

Disclaimer

I would like to mention that Julienne Spinnato played a very important role in the early phases of the project. She brought her technical expertise and coordinated within Progexia, before her career path led her to new projects in a new company.

Abstract

Anxiety and depression may have serious disabling consequences for health, social, and occupational outcomes for people who are unaware of their actual health status and/or whose mental health symptoms remain undiagnosed by physicians. This article provides a big picture of unrecognised anxiety and depressive troubles revealed by a low score on the Mental Health Inventory-5 (MHI-5) with the help of machine learning methods using the 2012 French National Representative Health and Social Protection Survey (Enquête Santé et Protection Sociale, ESPS) matched with yearly healthcare consumption data from the French Sickness Fund. Compared to people with no latent symptoms who did not declare any depression over the last 12 months, those with unrecognised anxiety or depression were found to be older, more deprived, more socially disengaged, at a higher probability of adverse working conditions, and with higher healthcare expenditures backed, to some extent, by chronic conditions other than anxiety or mood disorder.

A replication ebook is available on Github: codes (ebook)

The corresponding R codes are also available on Github: GitHub

Figure 1 displays the distribution of the Mental Health Inventory score (mental health indicator) across three groups: individuals who reported experiencing depression in the past month, those who did not answer the question, and those who stated they did not experience any depressive episodes in the past month. The vertical dashed line represents a threshold above which there is reason to believe that individuals with scores higher than this cut-off may be experiencing anxiety or depression. In this paper, we focus on the group of individuals who declare not having experienced depression but exhibit a low score—referred to as the imaginary healthy.

Figure 1: Density of MHI-5 Scores According to Self-reported Depression Status.