Regulation of the market for professional home help for dependent elderly people.

Summary The market for professional home help for dependent elderly people in France is regulated. The APA makes part of the demand for professional home help financially viable, while certain professional help structures are subject to fees and are obliged to respond to all the requests they receive. These regulation policies are decentralized at the level of the departmental councils and aim to reduce financial and geographical inequalities in access to professional help within each department. The goal of the thesis is to determine whether these policies of reducing intra-departmental inequalities lead to inter-departmental inequalities. The first chapter of the dissertation uses a survey of departmental councils to determine whether the decentralization of regulatory policies leads to significant policy heterogeneity across departments. The second chapter of the thesis analyzes the impact of the observed heterogeneity. This chapter proposes an estimation of the elasticity of the demand for home help of dependent elderly people, using a national survey. The third chapter of the thesis analyzes, within a department, the distribution of public financing according to income and its impact on consumption differentials. For this we use billing data from a home help service. Finally, the fourth chapter of the thesis proposes a theoretical model of a mixed market, studying the effects of the service obligation of a part of the market structures on the quality of the assistance offered.