Medical spending in France
Institute of Fiscal Studies, 27/03/2015
Pierre-Yves Geoffard
Grégoire de Lagasnerie
Christelle Gastaldi-Ménager
Data extraction:
Marjorie Mazars et Sébastien Rivière
March 2015
1
Plan
 The French health care system in a nutshell
 Basic trends in health care expenditure
 Data
 Concentration of medical spending (Where
we stand)
 Persistence of medical spending over time
(Where we stand)
March 2015
2
The French health care system in a nutshell
Source : National Health Accounts 2013
March 2015
3
Supply side
 Outpatient care :
– Fee for services with private practice for physicians
– Pay for performance
– Freedom of establishment for physicians
 Inpatient care :
– Majority of DRG payment + Global budget for specific
missions (teaching, research, emergency care)
– Majority of public beds (62% of public beds, 14% of private
not for profit beds, 24% of private for profit beds)
March 2015
4
Universal health care insurance : a two-tier system mixing public and
private insurance
• Funding in 2013:
Mandatory public insurance
Supplementary private insurance
Premium dependent on : Age, area of living
Tax
28,2Bn€; 15%
Incentives in order to avoid medical screening
Social Security
Contribution
85 Bn€; 47%
CSG tax
63,7Bn€; 35%
Group complementary health insurance to
employees with tax incentives and individual
contract
• Financing by type of care
Mandatory Public insurance and
Government
Complementary private insurance
Out of pocket
77,4%
13,8%
8,8%
Inpatient care
91,0%
5,3%
2,4%
Outpatient care
62,9%
22,2%
13,0%
Drugs
67,5%
14,3%
16,9%
Total Medical consumption
Source : National Health Accounts 2013
March 2015
5
Illustration of the two-tier system mixing public and private insurance in
2013 for each medical expenditure
Social Security Price
General case
“Chronic
Disease
expenditures"
Mandatory Public Insurance
Reimbursement
Balance Billing
Complementary private
insurance reimbursement
Social Security Price
Out of
pocket
Balance Billing
Mandatory Public Insurance Reimbursement
Out of
pocket
(1)
(15% of the population has at least one chronic disease, called ALD)
CMU-C
The poorest
Income<720€/month
Social Security Price
Mandatory Public Insurance
Reimbursement
Forbidden
Free
government
insurance
-
(7,1% of the population in 2013, Source : Fonds CMU)
(1) : Complementary private insurance reimbursement
March 2015
6
Total current expenditure - 2013
 Total current expenditure : 247 billion €, 11,7% GDP (11,6% in 2012
and 11,5% in 2011)
Inpatient care
9%
2%
Physicians
5%
Nursing care, physiotherapist
35%
Drugs
8%
Others (medical devices +
medical transportation)
Medical care
consumption
•
187 Bn€
•
76% of Total
current
expenditure
Long term care
9%
Subsistence allowances
14%
13%
5%
Preventive care
Others
Source : National Health Accounts 2013
March 2015
7
 Basic trends in health care expenditure
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
8
France spends more on health than most OECD countries
Total current expenditure, % gross domestic product
18
16
United States
14
Netherlands
12
France
10
Germany
8
United Kingdom
6
4
Source : OECD Health Data, 2013
March 2015
9
Public spending represents around 77% of healthcare expenditure in
France
100%
8.8
8.9
9.3
9.2
9.2
9.2
9.0
8.8
13.0
13.1
13.4
13.4
13.6
13.7
13.8
13.8
78.2
77.9
77.3
77.4
77.3
77.1
77.2
77.4
2006
2007
2008
2009
2010
2011
2012
2013
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Statutory Health Insurance + Government
Complementary private insurance
Out-of-pocket
Source : National Health Accounts, 2013
March 2015
10
Medical care consumption by function of health care
100%
90%
11%
11%
11%
11%
11%
11%
12%
6%
6%
6%
6%
7%
7%
7%
7%
Others (medical devices + medical
transportation...)
17%
17%
17%
17%
17%
17%
17%
17%
Nursing care, physiotherapist
20%
20%
20%
20%
20%
19%
19%
18%
12%
80%
70%
60%
50%
Physicians
40%
Drugs
30%
20%
46%
46%
46%
46%
46%
46%
46%
46%
Inpatient care (DRG + Global
budget payment)
10%
Only DRG payments in our data
0%
2006
2007
2008
2009
2010
2011
2012
2013
Source : National Health Accounts, 2013
March 2015
11
 Data for micro analysis
March 2015
12
Macro-Micro data
National accounts data
Micro data
Private insurance and
out of pocket
Outpatient care
Pharmaceutical
Inpatient
care
DRG payments to
hospitals
Reimbursement
data
Total
spending in
the database
used
No information
private insurance
reimbuirsment
Reimbursment by
the National health
insurance funds
Psychiatry, rehabilitative care
in public hospitals (17%)
Global budget (around 10%)
Lump-sum payment to nursing home for
elderly people
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
13
Collection of data: administrative database, the French public
insurance system
Universal mandatory insurance through occupation-based funds
Fund for employees
(General Scheme, since
1945)
Independant
workers fund
Agricultural
workers fund
5%
 7%
Including civil servants and
students
84% of the population
Source : Sniiram at a glance : http://www.ameli.fr
Other small
funds (SNCF,
RATP,…)
 4%
Collection of data: Data integration and linkage methods (1/2)
Local offices of the sickness funds
Nominative local database
Claims
Agricultural
Claims
workers
Independent
Claims
workers
General scheme
+ details on beneficiaries and
professionals
Source : Sniiram at a glance : http://www.ameli.fr
Anonymization
National data warehouse
SNIIRAM
Collection of data: Data integration and linkage methods (2/2)
Hospital stays in public hospitals
Linkage with the national hospital discharge
database called PMSI
National data warehouse
SNIIRAM
• Outpatient care
• Hospital stays in
private hospitals
No hospital stays in
public hospitals
Linkage with the register of deaths
 Date of death
Access to SNIIRAM data is limited to the 3 last years + the current year (i.e. today from
2012 to 2014), but a specific request is possible - if justified - for a deeper access
Source : Sniiram at a glance : http://www.ameli.fr
16
SNIIRAM: Summary of data available
Main data available
•
Information about insured people
•
•
•
•
•
•
•
•
•
•
« Chronic disease expenditures »
Long term chronic disease (ICD10)
Information about medical consumption
•
•
•
•
•
Reimbursed drugs and biological tests
Medical procedures and devices
GP and specialists visits
Other health care professionals
Hospital
• Diagnoses (main, associated, related)
• ICD10 and Diagnosis-related groups
• Ambulatory visits in hospital
• High cost drugs and medical devices
Source : Sniiram at a glance : http://www.ameli.fr
Information about insured people
•
Age, gender
Area of residence
Information about chronic disease
•
•
•
Data not available
•
Hospital
•
•
•
•
Socioeconomic status (income, employment
status…)
Risk factors (Smoking alcohol use, exercise,
diet, family history, Weight, overweight…BMI)
Results of laboratory tests…
Diagnosis
Observance
Over the counter drugs
Causes of death
Exams included in DRG« price »
Drugs used during hospital stay except for
most costly and necessary drugs (specific list)
Long term hospitalizations in public hospitals
(psychiatric and rehabilitative care)
Supplementary private insurance
17
The sample used : The Echantillon généraliste de bénéficiaires
 The Echantillon généraliste de bénéficiaires (EGB)
• Permanent representative sample of the population protected
by French health insurance (1/97th)
• For this study, data from 2008 to 2013
 The database includes:
• Around 500,000 people covered by the National Health
Insurance Fund for Salaried Workers (84% of the total
population)
• All SNIIRAM‘s data for people with healthcare consumption
during the year
March 2015
18
Representativeness of the Echantillon Généraliste des Bénéficiaires
(EGB) by age and gender in 2008
20%
2008 - National Institue of statistics and
economic studies
18%
16%
2008 - EGB
14%
12%
10%
8%
6%
4%
2%
0%
Below
15
years
old
15-19
years
old
20-24
years
old
25-29
years
old
30-34
years
old
35-39
years
old
40-44
years
old
45-49
years
old
50-54
years
old
55-59
years
old
60-64
years
old
65-69
years
old
70-74
years
old
75-79
years
old
80-84
years
old
85-89
years
old
90
years
old
and
over
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
19
Definition of the different types of care analyzed in this study
Healthcare basket
Outpatient care
Drugs
Inpatient care
March 2015
•
•
•
•
•
•
•
General practitionner
Specialist
Dentist
Nursing care, psychoterapist…
Biological test
Medical devices
Transportation
•
All reimbursed drugs
• Include most costly and necessary drugs used during
hospital stays
•
Only DRG payments
• Medical, surgical and obstetrics in private clinics and
public hospitals
• Psychiatry and rehabilitative care only in private hospital
• Emergency care
20
 Section 4 : Basic micro facts on the concentration of medical
spending
March 2015
21
Database used in the Section 4
2008
2009
2010
2011
2012
2013
500 758
504 151
522 967
522 313
527 476
533 580
38,9
39,1
38,9
39
39,2
39,4
38
38
38
38
39
39
0 to 24 years old
151 738
(30%)
151 244
(30%)
160 577
(31%)
160 680
(31%)
161 205
(31%)
161 700
(30%)
25 to 64 years old
272 157
(54%)
274 464
(54%)
282 097
(54%)
278 837
(53%)
280 228
(53%)
282 461
(53%)
65 years old and over
76 863
(16%)
78 443
(16%)
80 293
(15%)
82 795
(16%)
86 043
(16%)
89 419
(17%)
258 435
(52%)
260 369
(52%)
270 006
(52%)
270 268
(52%)
273 131
(52%)
276 271
(52%)
Total (N)
Age
Mean
Median
% Women
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
22
Increasing average health care expenditure by type of care (20082013)
Inpatient care
Constant € 2008
2,000 $
1708€
1805€
1793€
Outpatient care
1907€
Drugs
1889€
1905€
1,800 $
1,600 $
387 $
376 $
358 $
347 $
820 $
823 $
827 $
711 $
708 $
731 $
2011
2012
2013
384 $
374 $
1,400 $
1,200 $
1,000 $
804 $
808 $
566 $
614 $
601 $
2008
2009
2010
768 $
800 $
600 $
400 $
200 $
0$
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
23
Average health care expenditure adjusted for age effect by gender
Constant € 2008
2,100 $
2,000 $
1,900 $
1,800 $
1,700 $
1,600 $
1,500 $
2008
2009
2010
2011
2012
2013
Women : Total expenditure
Women : Total expenditure adjusted for age effet
Men : Total expenditure
Men : Total expenditure adjusted for age effet
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
24
Average medical spending by expenditure quintile and gender (65
years old and over)
18,000 $
16,000 $
Constant € 2008
14,000 $
12,000 $
quintile 1
10,000 $
quintile 2
quintile 3
8,000 $
quintile 4
6,000 $
quintile 5
4,000 $
2,000 $
0$
2008
2009
2010
2011
2012
2013
Men 65 years old and over
2008
2009
2010
2011
2012
2013
Women 65 years old and over
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
25
Medical spending by type of financing, age and “health status” in 2013
0 to 24 yold
100%
385 €
90%
80%
205 €
70%
60%
50%
6,553 €
40%
30%
453 €
20%
10%
0%
0 to 24 years old without chronic disease
Statutory health insurance (Public)
0 to 24 years old with chronic disease
Private insurance and out of pocket
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
26
Medical spending by type of financing, age and “health status” in 2013
25 to 64 yold
100%
575 €
90%
80%
325 €
70%
60%
50%
5,538 €
40%
30%
455 €
20%
10%
0%
25 to 64 years old without chronic disease
Statutory health insurance (Public)
25 to 64 years old with chronic disease
Private insurance and out of pocket
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
27
Medical spending by type of financing, age and “health status” in 2013
65 and over
100%
758 €
90%
80%
602 €
70%
60%
50%
6,669 €
40%
30%
1,114 €
20%
10%
0%
65 years old and over without chronic disease
Statutory health insurance (Public)
65 years old and over with chronic disease
Private insurance and out of pocket
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
28
Inpatient Expenditure by type of financing and “health status” in 2013
0 to 24
100%
23 €
113 €
90%
80%
70%
60%
50%
210 €
4,230 €
40%
30%
20%
10%
0%
0 to 24 years old without chronic disease
Inpatient care Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
0 to 24 years old with chronic disease
Inpatient care Private insurance and out of pocket
29
Inpatient Expenditure by type of financing and “health status” in 2013
25 to 64
100%
31 €
90%
119 €
80%
70%
60%
50%
250 €
40%
2,500 €
30%
20%
10%
0%
25 to 64 years old without chronic disease
Inpatient care Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
25 to 64 years old with chronic disease
Inpatient care Private insurance and out of pocket
30
Inpatient Expenditure by type of financing and “health status” in 2013
65 and over
100%
86 €
90%
178 €
80%
70%
60%
50%
578 €
40%
3,025 €
30%
20%
10%
0%
65 years old and over without chronic disease
Inpatient care Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
65 years old and over with chronic disease
Inpatient care Private insurance and out of pocket
31
Outpatient expenditure by type of financing, “health status” in 2013
0 to 24 y old
100%
253 €
90%
80%
162 €
70%
60%
50%
1,557 €
40%
30%
191 €
20%
10%
0%
0 to 24 years old without chronic disease
Outpatient care Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
0 to 24 years old with chronic disease
Outpatient care Private insurance and out of pocket
32
Outpatient expenditure by type of financing, “health status” in 2013
25 to 64
100%
381 €
90%
80%
311 €
70%
60%
50%
1,601 €
40%
30%
280 €
20%
10%
0%
25 to 64 years old without chronic disease
Outpatient care Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
25 to 64 years old with chronic disease
Outpatient care Private insurance and out of pocket
33
Outpatient expenditure by type of financing, “health status” in 2013
65 and over
100%
444 €
90%
80%
458 €
70%
60%
50%
2,363 €
40%
30%
447 €
20%
10%
0%
65 years old and over without chronic disease
Outpatient care Statutory health insurance (Public)
65 years old and over with chronic disease
Outpatient care Private insurance and out of pocket
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
34
Drug expenditure by type of financing, “health status” in 2013
0 to 24
100%
59 €
90%
80%
35 €
70%
60%
50%
649 €
40%
30%
47 €
20%
10%
0%
0 to 24 years old without chronic disease
Drugs Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
0 to 24 years old with chronic disease
Drugs Private insurance and out of pocket
35
Drug expenditure by type of financing, “health status” in 2013
25 to 64
100%
122 €
90%
80%
65 €
70%
60%
50%
1,369 €
40%
30%
86 €
20%
10%
0%
25 to 64 years old without chronic disease
Drugs Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
25 to 64 years old with chronic disease
Drugs Private insurance and out of pocket
36
Drug expenditure by type of financing, “health status” in 2013
65 and over
100%
174 €
90%
80%
170 €
70%
60%
50%
1,174 €
40%
30%
239 €
20%
10%
0%
65 years old and over without chronic disease
Drugs Statutory health insurance (Public)
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
65 years old and over with chronic disease
Drugs Private insurance and out of pocket
37
Average expenditure by age (2008, 2013)
7,000 $
Average expenditure 2008
6,000 $
Average expenditure 2013
5,000 $
4,000 $
3,000 $
2,000 $
1,000 $
0$
0 to 4
years
old
5 to 9
years
old
10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to74 75 to 79 80 to 84 85 to 90 90 years
years
years
years
years
years
years
years
years
years
years
years
years
years
years
years
years old and
old
old
old
old
old
old
old
old
old
old
old
old
old
old
old
old
older
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
38
Average care expenditure by age and type of care (2008, 2013)
Inpatient care
2,500 $
2,000 $
1,500 $
Inpatient care
2008
1,000 $
500 $
Inpatient care
2013
0$
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
39
Average care expenditure by age and type of care (2008, 2013)
Outpatient care
2,500 $
2,000 $
1,500 $
Outpatient care
2008
1,000 $
500 $
Outpatient care
2013
0$
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
40
Average care expenditure by age and type of care (2008, 2013)
Drugs
2,500 $
2,000 $
Pharmaceuticals
2008
1,500 $
1,000 $
500 $
Pharmaceuticals
2013
0$
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
41
Concentration of medical expenditures
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
42
Concentration of medical spending: “big spenders”
 “Big spenders” : top 10% with highest expenditure.
 Total medical expenditure : big spenders concentrate 62% of total
spending (Lorenz curve)
 Concentration of spending decreases with age : (Lorenz curve)
•
•
0 to 24 years old : big spenders concentrate more than 60% of total spending
65 years old and over : big spenders concentrate 51% of total spending
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
43
Concentration of medical spending: “health status”, type of care
 Concentration of spending increased between 2008 and 2013 :
among those with chronic disease, big spenders concentrate (Lorenz
curve)
•
•
2008 : 45% total spending
2013 : 48% of total spending
 Outpatient care (cost / reimbursement): (Lorenz curve)
•
•
Big spenders concentrate 49% of total outpatient spending
Big spenders concentrate 57% of outpatient reimbursement
 Drugs : (Lorenz curve)
•
•
Big spenders concentrate 58% of total drugs spending
Big spenders concentrate 67% of drugs reimbursement
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
44
 Section 5 : Persistence
• Longitudinal approach of medical spending (6 years)
• Correlation and concentration of medical spending over
time
March 2015
45
Section 5 : Database

Cohort follow up from 2008 to 2013

500 758 individuals in 2008 at inclusion (attrition due to death or change of
insurance schemes of 66 742 individuals, 13% of the population observed in
2008)
2008-2013
Constant € 2008
2,200 $
Age
38 years old in 2008
2,000 $
1,800 $
1,600 $
0 to 24 years old
25 to 64 years old
65 years old and over
% Women
126 779
(30%)
245 648
(57%)
61 589
(14%)
226 520
52%
1,518 $
Average total expenditure
1,862 $
1,724 $
1,641 $
1,956 $
2,087 $
1,400 $
1,200 $
1,000 $
800 $
600 $
400 $
200 $
0$
2008
2009
2010
2011
2012
2013
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
46
Cumulative distribution of total medical spending
1
0.9
0.8
0.7
0.6
0.5
2008
0.4
0.3
2008 and 2009
0.2
2008 to 2013
0.1
0
0
5000
10000
15000
20000
25000
30000
35000
40000
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
47
Measures of concentration : medical spending over 1, 2 and 6 years
Total medical spending
1 year
(2008)
2 years
(2008-2009)
6 years
(2008-2013)
Gini coefficient on
medical spending
0,71
0,67
0,64
Percentage spent
by top 1% of
spenders
19,5%
18%
15%
Percentage spent
by top 10% of
spenders
56%
53%
50%
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
48
Correlation coefficients with 2008 health expenditure by year and
health status
Inpatient care
1
0.9
0.8
0.7
Inpatient care ALD 2008
0.6
0.5
0.4
0.3
Inpatient careNON ALD 2008
0.2
0.1
0
2008
2009
2010
2011
2012
2013
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
49
Correlation coefficients with 2008 health expenditure by year and
health status
Outpatient care
1
0.9
0.8
0.7
Outpatient care ALD 2008
0.6
0.5
0.4
0.3
Outpatient care NON ALD 2008
0.2
0.1
0
2008
2009
2010
2011
2012
2013
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
50
Correlation coefficients with 2008 health expenditure by year and
health status
Drugs
1
0.9
0.8
0.7
Pharmaceuticals ALD 2008
0.6
0.5
0.4
0.3
Pharmaceuticals NON ALD 2008
0.2
0.1
0
2008
2009
2010
2011
2012
2013
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
51
Total medical expenditure transition matrices : whole pop, by decile
Scale:
Decile in 2009
Decile in 2010
Decile in 2013
Decile
in 2008
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
52
Total medical expenditure transition matrices : people with chronic
disease, by decile
Scale:
Decile
in 2008
D1
D2
D3
D4
D5
D6
D7
D8
D9
D10
Decile in 2009
Decile in 2010
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
25 7 7 9 9 10 10 7 7 9
18 19 14 10 8 7 7 5 4 8
10 13 15 14 11 10 8 7 5 8
5 7 13 16 13 12 10 8 7 9
3 4 6 12 18 15 13 10 7 10
2 2 4 6 12 21 18 14 10 11
1 1 2 3 7 14 23 21 14 14
0 1 1 2 3 7 16 29 24 16
0 0 1 1 1 3 7 18 39 29
0 0 0 1 1 2 3 8 21 64
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
17 5 4 4 5 6 8 12 17 22
14 15 10 9 8 8 8 7 6 14
9 11 13 11 9 9 9 9 8 13
5 7 11 13 12 11 10 10 9 13
3 4 6 10 14 15 13 11 9 14
2 3 3 6 11 18 17 14 11 15
1 1 2 3 7 13 21 19 16 16
1 1 1 2 3 7 16 27 22 20
1 0 1 1 2 3 8 20 35 30
1 0 1 1 1 2 4 9 22 58
D1
D2
D3
D4
D5
D6
D7
D8
D9
D10
Decile in 2013
D1
D2
D3
D4
D5
D6
D7
D8
D9
D10
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
8 3 3 3 5 7 10 13 17 32
7 8 6 8 8 9 8 9 11 26
5 7 6 7 8 10 10 11 12 24
4 5 6 8 9 10 11 12 13 22
3 3 4 7 10 11 12 12 14 24
2 2 3 6 9 12 13 14 15 23
2 1 2 3 6 12 15 17 17 24
1 1 1 2 4 8 15 20 21 26
1 1 1 1 2 5 10 19 28 33
1 1 1 1 2 3 6 11 22 52
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
53
1 YR Transition matrix :
total exp, people with chronic disease, by percentile
Percentile
in 2009
Percentile
2008
0 1 2
0 12 0 0
1 16 0 0
2 0 25 0
3 0 21 0
4 0 0 34
5 0 0 21
6 0 0 0
7 0 0 0
8 0 0 0
9 0 0 0
10 0 0 0
11 0 0 0
12 0 0 0
13 0 0 0
14 0 0 0
15 0 0 0
16 0 0 0
17 0 0 0
18 0 0 0
19 0 0 0
20 0 0 0
21 0 0 0
22 0 0 0
23 0 0 0
24 0 0 0
25 0 0 0
26 0 0 0
27 0 0 0
28 0 0 0
29 0 0 0
30 0 0 0
31 0 0 0
32 0 0 0
33 0 0 0
34 0 0 0
35 0 0 0
36 0 0 0
37 0 0 0
38 0 0 0
39 0 0 0
40 0 0 0
41 0 0 0
42 0 0 0
43 0 0 0
44 0 0 0
45 0 0 0
46 0 0 0
47 0 0 0
48 0 0 0
49 0 0 0
50 0 0 0
51 0 0 0
52 0 0 0
53 0 0 0
54 0 0 0
55 0 0 0
56 0 0 0
57 0 0 0
58 0 0 0
59 0 0 0
60 0 0 0
61 0 0 0
62 0 0 0
63 0 0 0
64 0 0 0
65 0 0 0
66 0 0 0
67 0 0 0
68 0 0 0
69 0 0 0
70 0 0 0
71 0 0 0
72 0 0 0
73 0 0 0
74 0 0 0
75 0 0 0
76 0 0 0
77 0 0 0
78 0 0 0
79 0 0 0
80 0 0 0
81 0 0 0
82 0 0 0
83 0 0 0
84 0 0 0
85 0 0 0
86 0 0 0
87 0 0 0
88 0 0 0
89 0 0 0
90 0 0 0
91 0 0 0
92 0 0 0
93 0 0 0
94 0 0 0
95 0 0 0
96 0 0 0
97 0 0 0
98 0 0 0
99 0 0 0
3 4 5 6 7
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 0 0 0 0
8 13 0 0 0
0 14 0 0 0
0 0 0 0 0
0 0 15 0 0
0 0 10 7 0
0 0 0 24 0
0 0 0 18 0
0 0 0 19 0
0 0 0 14 0
0 0 0 13 0
0 0 0 9 2
0 0 0 0 15
0 0 0 0 13
0 0 0 0 14
0 0 0 0 12
0 0 0 0 10
0 0 0 0 18
0 0 0 0 8
0 0 0 0 4
0 0 0 0 9
0 0 0 0 9
0 0 0 0 8
0 0 0 0 5
0 0 0 0 9
0 0 0 0 6
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
6
2
5
6
4
2
1
3
1
4
3
2
6
3
1
1
3
2
1
2
2
1
0
1
1
1
1
1
1
1
1
0
1
0
1
1
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
0 0 0 4 4 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 4 0 0 4 0 0 0 0 0 0 4 0 0 0 0 0 0 8 0 0 0 0 0 0 4 0 0 0 4 0 0 0 4 4 0 4 0 0 0 0 0 4 4 4 0 4 0 0 0 4 0 4 0 0 0 4 0 0 0 4 0 0 0 4 4 0 0 0
0 3 3 0 3 0 3 0 0 0 0 0 0 3 3 0 3 0 0 0 0 0 3 0 0 3 0 0 0 0 0 0 3 0 0 3 3 3 0 0 0 0 0 3 0 3 0 0 0 3 6 0 0 3 0 0 0 0 3 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 3 0 0 0 3 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 11 0 4 0 0 0 0 0 0 0 4 0 0 0 0 0 4 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 4 0 0 0 0 0 0 7 0 4 4 0 0 0 0 0 4 0 0 0 4 0 11 0 0 4
4 4 0 0 0 0 0 0 0 0 0 0 4 0 4 0 4 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 4 0 4 0 0 0 0 0 0 4 0 0 0 0 0 0 0 8 0 0 0 4 0 0 0 4 0 0 0 0 0 0 8 0 4 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 3 3 0 0 3 3 0 3 0 0 0 3 0 0 6 0 3 0 0 0 0 3 0 0 0 3 0 0 0 0 9 0 0 0 3 0 0 0 0 0 0 0 0 3 3 0 0 0 3 0 0
0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 3 0 0 0 3 0 0 0 0 5 0 5 0 0 3 0 0 3 0 3 3 0 0 3 5 3 0 3 0 0 3 5 0 3 0 0 8 0 0 0 0 0 0 5 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0 2 0 2 2 0 0 0 0 0 2 0 0 2 2 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 2 7 0 2 0 0 2 2 0 0 9 2 0 2 7 0 2 2 4 0 4 2 0 2 0 2 0 2 0 2 0 2 2 0 4
3 0 0 0 3 0 0 0 0 0 3 0 0 3 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 3 0 0 0 3 0 0 0 0 0 0 3 0 0 0 3 0 0 0 0 3 8 0 0 0 0 3 0 3 3 0 0 3 0 0 3 0 0 0 5 3 3 3 5 3 0 0 3 0 0 3 0 0 0 0 0 0 3 0 0 0
2 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 2 2 2 2 0 0 0 0 0 0 0 0 2 0 2 5 0 0 0 0 2 0 0 0 0 0 0 0 2 0 0 2 5 0 0 0 0 0 0 2 0 5 5 0 2 2 0 0 0 2 0 5 0 0 2 0 0 0 2 0 2 0 0 2 5 0 5 0 0 0 2 2 0 0 2
3 0 0 0 0 3 0 0 3 0 0 3 0 0 0 3 0 0 0 3 3 3 0 0 3 3 0 0 3 3 0 0 0 6 0 0 3 0 0 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 3 0 3 0 3 0 3 3 3 0 0 0 0 0 0 0 0 0 0 3 3 6 0 3 0 0 9 0 0 0 0 0 0 6 3
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 3 0 3 3 0 0 0 0 3 0 0 0 0 0 3 3 0 3 0 0 0 5 0 0 3 3 0 5 0 0 5 0 0 0 0 0 3 5 0 3 3 0 0 3 5 0 0 3 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3
3 3 0 0 2 0 0 2 2 0 0 0 3 0 0 3 0 0 2 2 2 2 0 0 0 0 3 0 2 0 2 2 0 2 0 3 3 2 2 0 0 2 3 0 0 0 2 0 2 0 3 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 2 2 3 2 2 0 0 3 2 0 0 0 0 0 0 2 2 2 2 0 0 3 0 0
2 3 2 2 2 0 0 2 0 2 2 0 2 2 0 3 0 0 0 3 3 2 3 0 0 2 2 0 2 3 0 2 0 2 2 0 0 0 0 0 2 0 0 0 0 0 2 2 2 0 0 0 0 0 2 0 0 0 0 3 0 0 0 0 2 2 0 2 0 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2 2 0 0 2 2
0 2 6 4 8 6 0 4 6 0 0 0 6 0 0 2 0 0 4 0 0 2 2 0 0 4 4 0 0 0 2 2 0 0 0 0 0 0 0 2 2 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 2 2 2 0 0 0 0 0 0 0 0 2 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 4 2 0 2 6 2 4 2 6 2 0 4 2 0 0 4 4 0 0 2 0 0 0 0 2 2 0 0 0 2 0 0 0 2 0 0 0 0 0 0 4 0 0 0 0 2 4 4 0 2 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 2 0 0 2 0 0 0
2 10 8 2 0 2 0 2 2 2 4 0 2 0 6 0 0 2 2 0 0 0 0 2 0 0 0 0 4 0 0 0 0 0 2 0 0 2 0 2 2 0 2 4 6 0 0 4 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0
0 3 3 0 5 5 0 2 2 2 0 2 2 3 3 0 2 0 0 0 0 2 2 0 3 0 5 0 0 2 2 2 0 0 3 0 5 2 0 0 0 2 0 0 2 0 0 0 2 0 0 0 0 0 2 3 2 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 5 2 0 0 0 2 3 0 0 0 0 0 2 0 2 0 0 0 0
5 0 2 4 2 4 0 5 0 2 2 4 0 2 2 2 5 0 5 2 2 2 2 0 2 4 0 4 2 0 2 2 0 0 0 0 0 0 2 0 0 0 0 0 0 4 0 0 0 0 0 2 2 0 0 2 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0 0 0 0 2 0 0 2 0 2 4
3 3 1 3 3 1 1 1 1 4 3 1 1 1 4 3 1 1 4 1 0 1 0 0 0 1 0 0 1 0 0 3 1 1 0 0 0 1 3 1 1 0 1 1 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 3 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0
2 0 2 5 3 2 3 2 0 2 2 3 2 5 0 0 0 3 0 0 0 2 3 3 0 0 0 0 0 0 2 0 0 3 0 3 0 2 0 2 0 0 0 0 2 2 2 2 2 2 0 2 0 0 0 0 0 0 0 2 0 0 0 3 2 3 0 0 0 2 2 0 0 0 0 0 2 2 0 0 2 0 0 0 2 0 0 0 0 0 0
1 0 4 0 1 0 1 0 1 4 3 3 5 3 3 1 1 5 0 0 0 4 1 0 1 3 0 0 5 3 1 0 0 3 0 0 0 0 0 4 1 0 3 0 1 1 1 0 1 1 0 0 1 1 1 0 3 0 0 0 0 0 0 3 3 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0
5 2 1 1 0 2 4 1 1 1 0 0 0 4 2 0 2 1 0 5 1 0 0 0 0 1 0 1 0 0 2 1 2 1 1 1 1 1 1 2 2 0 0 0 0 2 0 0 1 1 4 2 0 0 0 2 0 0 0 0 2 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 0 1 1 0 4
5 0 2 0 0 0 6 3 3 3 3 5 0 0 3 0 3 0 0 0 0 0 2 2 2 2 3 3 2 2 0 0 0 0 0 5 0 0 2 2 2 0 3 2 2 0 3 0 2 0 0 2 0 2 2 0 2 3 0 2 0 2 0 0 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
3 4 0 0 0 0 0 1 1 1 1 1 4 0 3 4 3 3 3 0 1 0 0 0 1 6 1 1 3 0 0 0 3 1 1 0 1 1 0 1 0 0 0 0 1 0 0 0 0 0 1 3 0 0 3 0 0 0 0 0 0 0 0 1 0 1 0 1 0 3 1 0 0 0 1 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0
1 1 0 0 1 2 0 0 1 0 2 0 1 2 4 4 2 6 0 1 1 1 4 1 0 2 1 0 1 4 2 2 2 0 1 0 0 1 2 4 2 1 0 4 1 0 0 1 0 1 0 0 1 0 1 1 0 2 0 0 1 0 1 0 0 0 0 0 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1
1 0 2 0 1 1 0 2 0 2 0 0 1 0 2 1 1 5 1 0 4 2 2 0 0 1 4 2 4 2 4 2 1 1 1 2 0 0 4 0 2 0 0 0 0 1 0 0 2 0 0 0 1 0 2 0 0 0 0 0 2 5 0 2 0 2 0 0 2 0 0 0 1 1 0 1 0 0 0 0 0 1 2 1 0 0 1 1 0 0 0
0 0 0 0 1 1 1 0 0 3 3 0 1 1 1 4 3 0 1 3 3 1 1 2 3 1 2 3 4 1 2 0 2 0 2 2 0 0 1 1 3 0 0 1 1 1 1 0 2 0 1 2 1 1 0 2 0 0 0 0 0 0 1 0 0 0 2 0 0 1 0 0 1 0 0 1 0 0 0 2 0 0 0 0 2 2 1 1 0 0 0
0 3 1 1 1 4 0 1 0 3 4 0 0 1 3 3 4 3 0 3 1 5 0 1 3 0 3 5 0 1 0 1 1 1 3 0 3 0 3 1 3 0 0 0 0 0 0 4 0 0 0 0 0 1 1 0 3 0 0 0 0 1 0 3 3 0 1 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 3 1 0
0 2 3 2 0 1 1 1 2 0 0 1 2 2 2 2 1 1 1 1 1 2 2 2 2 2 4 0 0 1 2 3 2 3 1 1 2 0 1 2 0 0 0 0 1 1 1 0 1 0 0 0 1 0 2 2 1 0 2 1 2 1 1 0 1 2 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 0 2 0 1 0 0 2 0 0 1
1 1 0 0 2 2 1 0 1 2 0 0 0 1 1 1 1 1 1 5 2 0 1 1 1 0 4 5 1 0 1 1 1 1 4 0 1 2 0 2 1 1 1 2 4 0 4 0 0 0 1 0 4 2 1 1 0 1 1 0 4 1 4 2 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 1 0
0 2 0 0 0 0 1 0 0 2 0 3 1 1 1 2 5 0 2 3 1 1 0 2 2 0 1 1 0 1 1 1 0 3 2 1 3 0 2 1 1 1 3 1 3 1 1 0 2 0 1 0 3 2 1 2 0 0 0 1 1 1 1 0 1 1 0 1 0 0 2 1 0 1 0 0 0 0 2 0 0 0 1 0 0 0 1 3 0 1 0
0 0 1 0 1 0 0 2 2 0 3 0 2 1 3 3 2 2 3 1 0 2 2 0 2 4 2 0 5 3 2 3 0 1 2 0 2 2 2 1 0 1 2 0 1 3 1 2 1 1 1 0 0 1 1 0 2 0 0 2 2 1 0 2 0 0 2 0 0 0 0 1 1 1 1 0 0 0 1 1 2 0 0 2 0 0 0 1 1 0 0
0 0 0 3 0 1 0 0 0 3 1 2 3 0 0 0 2 2 3 2 3 3 2 6 5 2 2 1 3 0 3 2 2 0 1 1 3 0 1 2 0 1 0 1 1 2 1 2 0 0 0 2 2 0 0 1 1 0 1 1 1 2 0 0 1 1 2 0 0 0 1 0 0 2 1 0 0 1 2 0 0 2 0 0 2 0 0 0 0 2 1
1 0 2 0 0 1 1 1 1 1 1 0 2 4 1 1 2 2 2 0 2 2 2 0 1 2 6 1 3 2 2 1 0 2 1 0 1 0 0 3 0 1 2 1 1 2 2 2 1 2 0 1 0 1 0 1 2 3 2 2 1 1 2 2 2 0 1 1 0 1 0 1 1 1 1 1 2 1 1 0 0 2 1 0 1 0 2 0 0 0 2
0 0 1 1 1 0 0 2 1 0 1 1 4 2 0 3 1 1 2 0 2 3 1 4 1 3 5 1 1 2 2 1 1 3 1 2 1 1 2 1 1 2 4 1 1 2 2 1 1 1 2 3 0 0 1 1 0 3 1 1 0 0 1 2 0 0 0 1 1 0 1 1 2 0 0 0 1 0 0 0 0 1 0 0 0 0 2 1 1 0 3
1 2 1 1 0 2 2 2 2 3 1 1 1 0 3 1 1 2 3 3 1 1 2 1 2 2 3 1 0 0 1 1 1 0 2 0 0 1 1 0 3 0 0 3 2 2 1 0 5 0 0 1 2 0 1 2 1 1 1 1 0 2 1 0 0 0 1 1 0 1 1 1 1 0 3 3 2 0 0 0 2 1 0 2 1 0 1 2 0 0 0
1 0 1 0 0 0 0 1 1 1 2 1 0 1 1 2 2 1 1 1 0 2 2 2 2 2 2 1 2 2 4 2 2 1 1 3 1 2 2 3 2 2 2 2 2 1 1 2 2 2 1 2 0 1 0 0 1 0 4 1 0 0 0 0 2 1 2 1 1 1 2 0 0 0 1 0 1 2 1 0 1 1 0 0 2 0 1 1 0 2 0
1 2 0 1 1 1 0 0 0 1 0 2 0 1 2 0 1 1 1 0 2 2 2 2 2 2 6 4 3 1 2 0 2 1 0 2 0 3 1 1 2 2 1 1 1 1 4 3 3 1 0 0 2 1 1 1 0 2 2 0 2 0 1 0 1 2 0 2 0 1 1 2 0 0 2 1 0 2 0 1 0 2 0 0 0 1 1 0 0 2 2
0 0 0 1 0 1 0 0 0 0 2 2 3 1 0 0 2 1 1 1 3 1 2 0 2 2 2 4 2 3 1 3 0 1 3 2 0 1 3 1 0 1 1 1 1 3 2 6 3 1 2 1 1 0 1 3 2 3 1 1 0 1 4 1 0 0 2 1 0 0 1 1 0 0 1 0 0 0 0 1 0 0 1 2 0 2 1 1 2 1 2
0 1 2 1 1 1 0 0 0 1 0 0 1 0 1 2 2 2 2 3 1 4 2 3 0 2 2 3 1 2 2 2 0 4 1 3 2 2 1 1 2 1 2 1 0 2 1 0 1 0 1 1 1 0 0 2 3 1 1 1 3 0 2 0 2 0 0 1 2 1 1 0 0 1 1 1 0 2 2 0 1 1 2 0 1 0 2 1 2 2 0
0 1 1 0 1 0 1 3 1 0 1 0 0 1 1 0 0 1 1 1 1 5 1 1 1 3 3 3 0 2 2 2 0 4 1 3 2 4 3 2 1 0 1 0 3 2 2 2 1 2 0 1 1 1 1 3 1 2 1 2 0 1 1 1 0 1 1 1 3 1 1 0 1 2 1 1 0 0 0 0 1 1 0 0 0 1 0 0 1 0 1
3 0 1 1 1 0 0 0 1 1 0 0 0 1 2 0 3 0 0 1 2 1 1 1 2 2 2 1 0 1 1 1 1 1 3 4 1 3 2 1 2 1 2 1 1 1 1 1 1 1 1 0 1 1 2 1 1 2 3 2 1 1 1 0 1 0 1 1 2 2 1 1 1 1 1 1 3 0 0 1 0 1 1 1 0 1 0 1 0 0 1
0 3 0 0 1 1 0 1 0 1 0 1 1 1 0 0 1 0 1 2 1 1 0 1 0 1 1 2 3 1 1 2 2 4 2 0 1 1 1 2 4 1 1 2 1 1 1 0 4 3 1 1 2 1 1 1 1 0 1 3 1 2 0 1 1 1 0 1 1 2 1 1 0 1 0 1 1 0 0 0 0 0 0 1 1 0 1 1 1 3 0
0 0 0 1 0 1 0 1 1 0 1 1 1 1 0 1 0 1 0 2 1 1 1 0 1 2 3 1 2 1 2 1 0 5 8 0 3 5 1 2 3 1 1 1 1 0 1 1 2 0 2 1 3 1 1 0 1 1 3 1 1 1 2 1 1 1 3 1 1 0 1 0 1 1 1 1 0 0 0 1 0 1 0 0 0 1 0 3 1 1 0
0 0 1 1 1 0 1 0 1 0 1 1 2 1 1 0 1 1 1 0 1 1 0 1 1 1 2 2 3 1 1 2 3 2 2 1 3 3 2 1 2 3 2 1 2 1 2 2 1 0 1 3 2 1 2 0 2 1 1 2 1 1 1 2 1 1 1 0 2 0 0 0 1 1 1 1 1 0 1 0 1 1 1 1 1 0 1 2 2 0 1
0 1 0 0 0 0 0 1 1 1 1 0 0 1 1 1 0 1 1 2 2 2 1 1 3 1 2 2 2 3 2 1 1 1 1 2 2 2 1 3 3 2 2 3 2 2 1 2 0 1 2 0 0 3 2 2 2 1 2 3 1 1 0 0 0 2 1 1 1 1 1 1 1 1 0 1 1 0 1 0 0 0 0 0 1 0 1 0 2 1 1
1 0 1 0 0 0 2 1 0 0 1 1 1 0 1 1 1 1 1 1 1 2 1 1 1 1 1 1 3 2 3 2 3 1 2 2 0 0 4 4 1 1 2 3 2 3 3 2 2 1 2 2 1 2 1 3 2 1 1 1 1 2 2 1 2 1 1 1 1 2 1 1 1 0 1 1 0 2 1 1 0 1 1 1 2 1 1 1 2 0 1
0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 1 1 2 0 0 0 1 2 1 2 2 0 2 0 2 1 2 2 1 3 3 1 3 2 2 1 1 1 1 3 1 2 1 0 0 0 2 0 1 1 2 0 0 0 1 1 1 1 2 2 2 0 0 1 0 1 1 0 0 1 1 2 1 0 0 0 1 1 0 2
1 0 0 1 1 0 0 1 1 1 0 0 0 0 1 0 1 0 0 1 2 1 2 2 2 1 1 1 1 1 1 1 3 1 2 2 4 4 1 3 2 2 2 1 2 3 2 2 1 3 2 1 2 2 1 1 1 2 1 0 1 2 0 1 1 0 2 1 3 1 2 0 1 4 1 1 1 1 1 1 0 1 1 1 1 2 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 2 0 1 2 0 1 1 2 2 2 2 0 3 4 4 4 2 2 1 2 0 1 2 0 5 3 1 0 1 2 2 1 1 2 2 0 0 1 0 2 2 1 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 1 1 1 0 0 2
0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 1 0 0 0 0 0 2 1 1 0 1 2 1 0 1 1 1 1 1 2 3 2 1 2 3 1 3 2 2 2 0 2 0 0 1 1 2 1 2 2 1 1 0 2 1 2 0 1 1 2 2 0 3 1 0 1 2 1 0 0 1 0 1 1 0 0 1 1 0 1 0 0 3
0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 1 1 1 2 0 3 2 2 2 1 5 1 5 1 2 2 1 2 1 1 2 4 1 2 0 1 3 2 1 1 3 3 2 1 1 1 0 1 1 0 1 1 1 1 2 2 1 1 0 0 0 0 0 1 1 0 1 0 2 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 3 2 4 3 2 5 2 2 3 3 1 3 3 1 3 1 4 1 2 2 1 2 1 3 2 1 3 1 1 2 0 3 2 2 1 0 1 0 1 2 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 2 1 0 0 1 0 1 0 1 1 1 1 1 0 1 1 1 2 1 1 1 2 3 4 2 4 2 2 2 2 3 3 2 3 2 4 2 1 2 2 1 0 2 1 1 2 1 1 1 2 1 1 1 2 2 2 2 1 1 0 0 1 1 2 1 1 1 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 2 0 0 1 2 1 1 0 3 2 3 2 2 4 3 5 3 2 3 5 1 0 3 3 1 2 0 2 2 0 1 1 1 1 2 1 1 0 1 1 0 1 0 1 1 1 0 2 1 2 0 0 2 1 1 0 0 1 0 1 3 0
1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 2 1 1 1 2 0 2 2 2 2 3 2 3 3 1 4 2 0 2 2 4 2 4 2 2 1 2 0 1 1 0 2 1 3 4 1 1 1 1 1 0 1 2 1 0 1 1 0 0 0 1 0 1 1 1 1 1 0 1
0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 1 1 1 1 2 1 2 1 1 1 2 1 3 2 2 3 3 2 3 2 2 2 3 3 3 3 2 2 2 1 2 3 3 1 2 2 1 2 1 2 0 2 0 1 1 0 0 2 1 1 2 1 1 0 1 1 0 2 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 0 1 1 2 0 1 2 1 1 1 1 2 2 2 3 3 2 3 4 3 5 2 2 2 2 1 2 2 2 2 2 2 1 1 2 1 1 4 3 1 1 2 0 1 1 1 1 1 0 2 2 2 0 2 0 1 0 0 1 1 1 1
0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 1 0 1 1 1 1 0 2 3 0 1 2 1 1 2 1 2 2 3 3 3 3 3 3 3 1 2 2 2 2 3 1 2 2 2 3 2 2 1 3 0 1 2 1 1 1 2 2 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 1 1 1 0 1 0 1 1 0 1 1 1 0 0 1 1 0 1 1 0 2 1 1 2 2 2 2 2 3 4 2 1 2 2 4 4 2 2 3 1 1 2 1 2 2 1 2 2 1 1 2 2 2 1 1 2 1 1 1 1 1 0 1 1 1 0 2 1 1 1 1
0 1 0 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 1 0 0 1 0 0 1 1 0 0 0 1 1 2 1 1 1 1 1 0 2 2 2 2 1 2 3 3 2 2 1 3 4 2 2 2 1 3 3 1 1 2 2 2 1 2 1 2 1 1 1 1 1 1 1 1 1 3 1 0 2 0 1 1 1 0 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 1 1 1 1 2 1 1 2 3 3 1 4 2 1 2 1 4 4 3 2 3 3 3 4 3 3 1 1 2 3 1 1 1 1 1 2 1 1 1 1 1 2 1 1 1 1 1 1 0 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1 2 1 1 2 2 2 2 2 2 2 2 2 1 3 2 3 3 2 3 2 3 2 1 2 2 3 2 2 1 3 2 2 1 1 1 1 1 1 1 1 2 1 0 0 1 2 1 0 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 1 2 1 2 0 1 2 1 3 1 2 2 2 1 3 3 2 3 3 2 3 3 3 2 2 3 3 3 2 3 2 1 1 2 2 2 2 1 1 1 1 0 1 0 1 1 0 1 1 0 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 1 2 3 3 1 3 3 1 2 4 3 2 2 1 2 2 3 4 1 2 2 2 2 2 3 1 2 2 1 1 1 1 1 2 1 1 1 1 1 1 2 2 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 0 0 0 1 1 1 0 1 1 1 1 1 2 2 1 2 3 2 2 2 1 3 3 3 3 2 3 1 3 3 2 3 1 2 3 2 2 2 1 1 1 2 1 1 2 1 0 1 2 3 2 2 1 1 0 2 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 1 0 1 1 1 2 0 1 1 1 1 2 1 2 2 3 2 2 3 3 2 3 3 4 2 3 3 4 2 3 1 2 1 2 2 2 1 1 1 1 1 2 2 2 1 1 1 0 2 1 1 1 1 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 1 0 0 1 1 0 1 1 2 3 2 1 3 2 3 3 3 3 2 3 4 3 3 3 3 2 2 3 1 2 1 3 1 2 1 1 1 2 1 1 1 1 1 1 1 2 1 2 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 1 1 2 1 1 0 1 2 2 2 1 2 2 3 3 2 2 4 3 3 5 3 3 2 3 2 2 3 3 1 2 2 2 2 1 2 0 2 1 2 2 2 2 1 0 1 1 1 2 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 2 1 2 2 1 2 2 2 2 2 3 5 2 2 4 3 2 3 3 3 4 2 2 2 1 2 2 2 2 2 1 3 0 2 1 1 1 1 1 2 1 1 1 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 1 1 0 1 1 1 1 1 1 2 1 3 2 2 2 3 2 2 3 2 3 2 5 3 3 5 4 2 2 2 2 3 2 2 3 2 1 1 1 2 2 1 1 1 2 1 2 1 0 1 1 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1 1 1 2 1 1 2 1 3 3 2 2 2 2 3 4 3 3 4 2 3 3 2 3 3 2 1 2 2 2 1 2 3 1 1 2 1 1 2 1 2 2 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 1 1 0 0 0 1 2 1 1 2 1 2 2 2 1 2 2 2 2 2 3 4 4 2 3 4 4 4 3 3 2 2 3 2 2 2 2 2 1 1 1 2 2 2 1 3 2 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 1 1 1 1 2 1 2 2 2 2 3 2 3 4 3 3 3 4 5 3 3 2 3 3 3 1 1 2 2 2 2 2 1 2 1 1 2 1 0 2 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 2 3 2 3 2 2 2 2 3 3 3 4 4 4 3 4 3 3 2 2 1 2 2 2 2 2 1 3 1 2 2 1 2 2 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 0 1 1 1 1 1 1 1 1 2 1 1 1 2 2 3 2 3 3 2 3 4 4 4 4 3 3 2 3 3 2 3 2 2 1 1 2 2 2 0 2 1 1 2 1 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 1 1 1 0 1 1 1 1 2 1 1 1 2 2 3 2 3 4 3 5 2 4 3 4 2 4 3 2 2 2 2 3 2 1 1 1 2 2 2 1 2 2 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 2 2 1 3 2 3 4 3 4 3 4 4 5 4 3 5 4 3 2 2 2 2 1 1 2 1 2 2 1 2 3 2 1
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1 1 2 1 2 3 1 2 2 2 3 3 3 4 4 4 3 4 3 3 4 3 3 3 2 2 2 2 2 2 2 2 2 2 2 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 1 2 2 2 1 2 1 3 3 3 2 4 4 4 4 4 4 3 4 3 4 2 3 3 3 2 2 2 2 2 2 3 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 1 0 1 2 2 2 1 2 2 1 2 2 2 3 3 4 3 4 4 4 5 4 3 3 4 2 2 2 2 2 3 3 3 2 1 3 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1 2 2 1 2 3 3 2 4 4 5 4 5 4 5 3 2 3 3 2 3 2 2 1 2 3 3 2 3 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 2 2 3 2 2 3 3 4 4 4 4 5 5 4 4 4 5 3 2 4 2 2 3 3 2 2 2 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 2 1 2 2 2 3 3 4 4 4 5 6 4 6 5 5 3 3 3 3 2 2 2 3 2 2 3 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 1 1 1 1 2 1 3 3 3 3 4 5 5 5 5 4 5 5 3 4 3 3 2 2 2 3 3 3 3 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 2 2 2 2 2 3 3 4 5 6 5 6 4 5 5 4 4 4 2 3 3 2 3 3 1 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 0 1 0 1 1 1 1 1 1 1 2 3 2 3 3 3 4 5 5 5 6 3 6 4 4 3 4 3 3 3 3 3 3 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 1 1 1 1 1 2 2 3 3 4 3 4 5 5 4 6 5 5 4 5 3 4 5 3 3 3 3 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 1 1 1 2 1 1 2 3 3 3 4 6 4 6 6 5 5 4 4 4 4 3 4 4 3 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 2 2 3 3 3 3 4 4 5 5 6 5 7 5 5 4 3 3 4 3 3 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1 1 0 1 1 1 1 1 2 1 2 2 3 2 2 3 4 4 5 5 6 6 6 5 5 5 5 4 5 4 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 1 0 1 1 1 1 1 1 2 1 2 2 3 3 4 4 5 6 7 6 7 5 5 5 5 4 4 4 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 1 1 1 1 1 2 2 2 2 1 2 3 3 4 4 5 6 7 7 6 5 5 6 4 4 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 2 1 1 2 2 2 3 2 4 4 4 6 6 7 7 7 6 6 5 5 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 3 3 4 5 5 6 7 7 8 7 6 5 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 0 1 1 1 1 1 1 1 2 1 2 2 2 3 2 3 3 4 4 5 6 8 10 9 6 7 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 3 3 4 4 5 5 8 9 12 9 7 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1 2 1 2 2 2 3 3 3 4 4 5 8 11 15 11 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 2 1 1 1 2 2 2 2 3 2 3 3 4 5 7 14 24 13
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1 2 2 2 2 2 4 5 6 16 44
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
54
5 YR Transition matrix :
total exp, people with chronic disease, by percentile
Percentile
in 2013
Percentile
2008
0 1 2
0 4 0 0
1 13 0 0
2 11 0 0
3 0 13 0
4 0 25 0
5 0 5 0
6 0 0 2
7 0 0 16
8 0 0 0
9 0 0 0
10 0 0 0
11 0 0 0
12 0 0 0
13 0 0 0
14 0 0 0
15 0 0 0
16 0 0 0
17 0 0 0
18 0 0 0
19 0 0 0
20 0 0 0
21 0 0 0
22 0 0 0
23 0 0 0
24 0 0 0
25 0 0 0
26 0 0 0
27 0 0 0
28 0 0 0
29 0 0 0
30 0 0 0
31 0 0 0
32 0 0 0
33 0 0 0
34 0 0 0
35 0 0 0
36 0 0 0
37 0 0 0
38 0 0 0
39 0 0 0
40 0 0 0
41 0 0 0
42 0 0 0
43 0 0 0
44 0 0 0
45 0 0 0
46 0 0 0
47 0 0 0
48 0 0 0
49 0 0 0
50 0 0 0
51 0 0 0
52 0 0 0
53 0 0 0
54 0 0 0
55 0 0 0
56 0 0 0
57 0 0 0
58 0 0 0
59 0 0 0
60 0 0 0
61 0 0 0
62 0 0 0
63 0 0 0
64 0 0 0
65 0 0 0
66 0 0 0
67 0 0 0
68 0 0 0
69 0 0 0
70 0 0 0
71 0 0 0
72 0 0 0
73 0 0 0
74 0 0 0
75 0 0 0
76 0 0 0
77 0 0 0
78 0 0 0
79 0 0 0
80 0 0 0
81 0 0 0
82 0 0 0
83 0 0 0
84 0 0 0
85 0 0 0
86 0 0 0
87 0 0 0
88 0 0 0
89 0 0 0
90 0 0 0
91 0 0 0
92 0 0 0
93 0 0 0
94 0 0 0
95 0 0 0
96 0 0 0
97 0 0 0
98 0 0 0
99 0 0 0
3 4
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 0
0 0
5 3
0 8
0 9
0 14
0 6
0 4
0 10
0 2
0 4
0 3
0 6
0 6
0 2
0 4
0 2
0 0
0 4
0 4
0 1
0 1
0 2
0 2
0 3
0 2
0 2
0 3
0 2
0 2
0 0
0 2
0 1
0 2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5
0
0
0
0
0
0
0
0
0
3
0
2
0
4
2
0
3
4
0
0
1
2
0
1
0
2
0
0
1
2
0
0
1
0
0
1
0
1
0
2
1
1
2
1
3
2
1
1
2
1
0
1
1
1
0
0
0
1
1
0
0
1
1
0
0
0
0
1
1
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
3
0
0
0
0
0
0
0
3
0
2
0
4
6
0
3
0
1
0
3
2
0
1
0
1
1
3
1
0
1
0
0
0
0
1
1
1
1
0
3
0
1
1
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
3
0
0
0
0
3
0
2
0
2
4
4
2
4
1
2
5
1
2
3
2
1
3
5
0
4
1
2
2
2
2
2
2
1
1
1
1
2
1
1
2
1
1
0
0
0
1
0
0
1
0
0
0
1
0
1
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
3
0
0
0
0
3
5
3
2
0
0
0
2
1
0
1
2
2
0
0
2
2
1
0
0
1
1
3
2
3
1
2
2
0
2
2
1
1
1
1
1
2
1
2
2
2
0
1
3
0
1
1
2
1
1
0
0
0
0
1
0
1
1
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 0 0 4 0 0 0 0 0 0 0 0 0 0 4 0 0 4 0 0 4 0 0 0 0 0 4 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 4 0 4 0 4 4 8 8 4 15 4 4 0
0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 3 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 3 3 0 3 0 0 0 0 0 0 0 0 0 3 0 3 3 0 6 0 3 0 0 0 0 0 0 0 0 0 0 3 3 3 0 0 0 0 10 0 0 3 0 3 0 3 0 0 6 0 0
4 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 0 0 4 0 4 0 0 0 0 0 0 0 7 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 4 0 0 0 0 0 0 4 0 0 0 4 0 4 0 4 0 0 0 0 0 0 0 11 7 11 4
0 0 0 0 4 4 0 0 0 0 0 0 4 0 0 0 0 0 4 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 0 4 4 0 0 4 4 0 0 4 0 4 4 0 8 8 0 0 0 4 4 0 0 0 0 0
0 0 0 3 0 0 0 0 0 3 3 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0 3 0 0 0 0 3 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 16 6 0 0 3 6
5 0 0 0 3 0 0 3 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 3 0 5 3 3 0 0 3 0 0 0 0 0 0 3 3 5 3 0 3 3 3 0 3 0 0 0 0 3 0 0 3 5 3 0 3 3 3 5 8 0
4 0 0 0 0 0 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 2 0 0 2 0 0 0 2 2 2 0 0 0 0 2 2 0 2 4 2 2 2 0 0 4 9 4 18 7 2 2 7
0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0 3 5 5 0 5 5 3 3 3 3 3 0 3 8 8 8 5 0
2 0 0 0 0 0 0 0 0 2 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 2 0 2 0 2 0 0 2 0 0 0 0 0 2 2 0 2 0 0 2 2 5 0 0 2 0 2 2 2 0 2 2 2 5 2 2 2 0 0 5 2 5 2 2 7
0 0 0 3 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 3 3 3 0 0 0 0 9 0 0 0 0 0 0 6 0 0 0 3 0 3 3 0 3 0 0 0 0 0 0 3 3 3 6 0 6 6 15
5 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 3 0 0 3 3 3 0 0 0 0 3 0 0 0 0 0 0 5 0 3 0 0 3 3 3 3 0 3 0 3 3 0 0 8 0 0 0 3 3 0 3 0 0 0 3 3 0 5 3 5
3 2 2 2 3 0 0 3 0 0 2 0 0 3 0 0 0 2 0 0 0 0 2 3 2 0 2 0 0 2 0 2 0 0 0 0 0 0 0 0 0 2 2 2 0 2 0 0 0 0 2 0 0 3 0 0 0 0 3 0 0 0 0 0 3 0 0 0 0 0 0 0 7 2 0 0 0 2 0 0 2 2 3 2 0 2 5 0 0 2 5
5 3 3 0 0 2 2 5 0 2 2 2 2 0 2 0 0 2 0 2 2 2 0 0 0 0 2 0 0 2 2 0 0 0 2 2 0 0 5 2 0 3 0 2 0 0 0 0 2 0 0 2 0 0 2 2 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 2 2 0 0 2 5 0 2 3 2
2 2 2 0 0 2 0 2 4 4 2 0 0 2 0 4 0 2 0 0 0 0 10 4 0 0 2 2 0 0 0 2 0 2 0 2 0 4 0 0 0 2 0 0 0 0 0 2 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 0 0 2 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 2
2 0 0 0 4 0 0 0 2 0 2 4 0 0 4 0 4 0 0 4 0 0 0 2 0 0 0 0 0 0 0 0 2 2 4 2 0 0 2 0 2 0 0 2 0 0 0 0 0 0 0 2 0 2 2 0 2 0 0 0 0 0 0 0 0 2 0 2 0 0 2 0 0 0 0 0 4 0 0 0 0 6 0 2 0 4 2 6 2 0 4
4 6 0 0 0 4 4 2 0 2 0 0 4 2 2 0 0 2 2 6 2 4 0 0 0 2 0 0 0 2 0 0 0 0 0 4 4 0 2 2 0 0 2 2 2 4 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 2 2 2 0 2 0 2 0 0 2 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 0 2 2 0 3 2 2 0 0 0 0 0 2 3 3 2 0 0 0 0 5 3 3 2 2 2 0 0 0 0 0 0 2 3 2 0 0 0 2 0 0 0 2 0 2 0 3 2 0 2 0 0 0 0 0 0 0 2 2 3 0 2 0 2 0 0 0 0 0 0 2 2 0 0 0 3 0 0 2 0 0 0 2 0 0 3 2 3
2 2 4 0 0 0 0 0 7 7 2 4 0 0 2 0 0 0 4 2 0 0 0 0 0 0 4 4 0 2 0 2 0 4 0 2 0 2 2 0 0 0 0 2 0 0 0 0 2 0 0 0 4 0 0 0 0 0 2 0 0 0 2 0 0 0 0 0 0 2 0 0 0 0 2 2 2 0 2 0 2 0 2 2 2 0 2 2 2 2 4
1 0 1 1 3 6 0 0 1 3 0 3 0 1 0 0 3 0 1 1 3 1 0 1 1 0 0 1 0 3 0 0 0 1 3 0 0 0 0 1 0 1 0 0 3 3 4 0 1 0 1 0 4 1 1 0 0 0 1 0 0 0 0 1 0 1 1 0 0 0 0 3 3 0 0 1 0 0 0 0 0 0 1 0 1 0 1 3 0 4 3
7 3 0 0 5 3 3 3 3 0 2 2 0 3 2 0 0 0 2 2 2 0 0 2 0 0 2 2 2 0 0 3 0 2 0 0 3 3 0 2 0 0 0 0 2 2 0 2 0 2 0 0 0 0 0 0 0 3 0 0 0 2 0 0 0 0 0 2 0 0 0 0 0 0 0 2 0 0 0 0 2 0 0 2 0 0 2 3 7 0 3
5 3 1 1 1 1 1 0 3 3 0 0 3 1 1 3 0 1 0 3 3 1 1 4 0 0 0 0 0 1 1 0 0 3 1 0 1 0 0 0 0 1 0 1 0 0 3 3 1 3 3 1 1 0 1 0 1 1 0 1 0 1 0 0 3 0 0 0 0 0 0 1 0 0 1 0 0 3 0 0 0 0 0 1 1 1 1 0 0 0 0
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1 1 0 3 1 1 0 0 4 1 1 0 0 3 1 3 3 0 4 3 0 0 1 1 0 0 1 0 1 0 1 1 0 1 1 1 0 1 3 1 1 0 3 1 0 1 1 0 3 0 1 0 1 4 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 3 1 1 0 3 1 0 1 1 1 0 0 1 0 0 0 0 0 1 3 3
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2 1 2 1 0 2 2 0 1 1 0 1 0 1 2 2 1 2 2 2 1 2 2 1 2 1 0 2 2 2 2 1 1 0 2 1 2 1 2 2 0 1 1 0 0 0 2 1 0 2 1 1 0 1 0 2 0 0 1 2 1 1 2 1 0 0 1 1 2 2 1 0 2 2 0 1 0 2 1 2 1 0 1 1 5 2 2 2 2 0 2
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1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 1 0 0 1 0 0 0 1 1 3 0 2 0 2 0 3 1 2 1 0 0 3 2 1 1 1 1 1 1 0 1 1 2 1 0 1 1 1 3 1 1 3 3 1 1 0 2 1 1 1 1 2 2 1 1 1 0 1 1 1 1 1 1 1 2 1 1 1 2 1 1 1 3
0 0 1 0 0 0 0 0 0 1 0 0 0 0 2 1 1 1 0 0 0 1 1 1 1 1 1 0 1 2 0 1 2 0 1 1 1 1 2 1 1 2 1 2 1 0 2 0 3 2 1 2 1 0 1 1 2 1 2 1 2 1 1 2 0 2 1 1 1 2 1 1 3 1 1 2 1 1 1 0 1 2 0 1 2 3 1 1 2 1 2
0 1 1 0 1 0 0 0 1 0 1 1 0 1 1 0 0 1 0 1 0 0 0 2 2 1 1 1 1 0 2 1 0 1 3 0 0 1 1 2 3 2 1 3 1 2 0 2 3 1 0 1 1 0 3 2 3 2 2 0 2 1 4 2 0 1 1 3 2 0 1 3 0 0 0 1 1 0 1 2 0 0 1 1 1 2 3 3 1 0 2
1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 2 1 0 0 1 1 0 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 2 1 1 2 1 1 0 1 0 2 2 1 3 0 1 1 2 1 2 0 1 1 1 1 2 2 1 2 1 2 2 2 1 1 0 1 1 1 3 0 1 1 1 1 2 3 1 1 2 1 1
2 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 1 2 0 1 2 1 2 1 1 1 1 2 1 1 1 1 1 1 2 2 1 2 1 2 1 1 2 2 1 1 2 1 1 2 1 2 2 2 1 2 2 1 1 1 2 1 2 1 2 1 2 1 2 1 1 2 1 1 2 1 1 1 0 2 2 3 1 1
1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 2 2 1 2 1 1 2 1 0 1 1 1 2 2 2 1 1 2 3 1 2 2 2 1 1 1 1 1 2 3 1 1 1 3 1 1 2 1 1 1 2 2 0 1 3 1 2 2 2 1 1 2 1 2 2 3 2 2
1 1 0 1 0 1 0 0 0 1 0 0 0 1 0 0 1 1 1 0 1 0 0 1 1 0 0 1 0 1 1 1 1 1 1 2 1 1 1 1 1 3 2 1 2 1 1 2 1 0 2 1 2 1 1 3 2 1 3 1 1 2 2 1 1 1 3 1 1 1 1 2 1 1 0 2 1 2 2 1 1 1 2 1 1 2 2 1 1 1 3
1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 1 0 0 1 2 0 1 1 1 1 1 1 1 1 2 2 1 1 2 2 1 1 1 2 2 2 2 1 1 2 2 2 1 1 2 1 1 1 2 1 2 2 2 3 1 1 2 1 2 2 2 2 1 1 1 1 0 2 2 1 2 1 2 2 3 3 1 3
1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 1 1 0 0 1 0 1 0 0 1 0 3 1 1 1 2 1 1 2 2 2 3 2 1 1 2 1 3 1 2 2 1 1 1 1 2 1 1 0 2 1 2 2 2 2 3 3 1 3 1 1 1 1 1 1 2 2 2 1 2 2 2 1 3
1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 0 0 1 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 2 1 2 1 3 3 2 2 2 1 2 3 2 2 1 2 1 3 3 1 2 3 2 1 2 1 1 1 1 2 1 1 1 1 1 2 1 1 1 2 2 2 1 2
2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 2 0 1 1 1 0 0 1 0 0 2 1 1 1 1 1 3 1 1 1 1 1 1 2 3 2 1 2 2 2 2 2 1 3 2 1 2 2 1 1 1 1 1 1 1 1 1 1 0 2 2 2 3 1 1 1 1 2 3 2 2 1
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0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 1 1 1 2 2 2 3 2 2 2 2 2 1 1 2 2 3 3 1 0 2 1 0 2 2 2 0 1 2 2 2 2 2 2 2 1 2 2 1 2 1 2 2 3 2 1 1 3 2 1
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 1 2 0 1 1 0 1 1 1 1 1 1 2 2 3 1 2 1 1 1 3 1 1 1 2 1 2 2 1 2 2 1 1 2 1 1 0 1 3 1 1 1 2 2 2 2 2 2 1 2 2 2 2 3 5
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 2 0 1 0 1 1 2 1 1 0 1 1 1 2 2 1 1 1 2 3 1 3 2 2 3 2 2 2 2 1 1 2 2 3 1 2 2 2 2 1 1 2 2 1 2 1 1 1 2 2 3 2 1 3 2
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 1 0 1 0 0 1 0 1 2 1 1 1 1 2 0 2 2 3 1 2 1 1 2 1 2 2 2 1 1 2 1 2 1 1 2 0 2 2 2 2 2 2 2 1 1 2 1 2 3 2 2 3 2 3 4 2 4
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 1 1 2 1 1 1 1 1 1 2 1 1 1 2 2 1 2 1 2 1 2 2 1 2 2 2 1 3 2 1 2 3 2 2 1 3 2 2 1 2 2 2 1 2 2 1 2 2 2 1
1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 2 2 1 1 2 1 2 2 3 2 2 3 1 2 2 2 2 2 2 3 2 2 2 1 1 2 2 2 2 2 1 1 2 1 2 2 1 2 3 2 3 2 2 2 2
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 1 1 1 1 1 1 1 2 2 1 2 1 1 1 1 1 1 2 2 2 3 2 2 2 3 2 2 3 3 2 2 2 2 2 1 2 1 1 2 2 1 1 2 3 2 2 3 3 1 2 2 1
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 1 1 1 1 0 1 1 1 1 1 1 2 1 2 1 2 1 1 1 1 1 1 1 2 2 2 2 1 2 2 2 2 3 2 2 3 2 2 1 2 3 1 2 2 2 2 2 1 1 2 2 2 2 2 2 2 2 2 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 1 0 1 1 1 1 0 0 1 0 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 2 2 2 1 2 2 2 2 2 3 1 2 2 2 2 2 1 1 2 2 2 2 2 1 2 3 2 4 2
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 1 0 0 1 1 1 0 1 1 1 2 2 1 2 3 2 1 2 2 2 1 2 2 2 2 2 1 3 2 2 3 2 2 2 2 2 1 2 2 1 1 2 2 3 2 3 2 2 2 4 3 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 2 1 1 1 2 3 2 2 2 3 2 3 2 2 2 3 3 1 1 2 2 2 2 3 1 2 3 2 1 2 1 1 2 3 2 2 2 2 2 2 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 2 1 1 2 1 1 2 1 2 1 2 3 2 2 2 3 2 1 3 2 3 2 2 2 2 2 2 2 2 2 2 2 1 2 3 1 2 2 2 3 3 3 4
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 1 1 2 2 1 1 1 2 1 1 2 1 2 2 2 2 3 2 2 3 2 1 3 2 3 3 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 2 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 1 1 1 1 2 1 2 1 2 2 2 3 2 2 2 3 3 2 2 2 2 2 2 2 3 2 3 3 2 2 3 1 2 1 2 2 2 2 2 3 2 2
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 1 0 1 1 1 2 1 2 2 2 2 2 2 2 3 3 2 2 1 3 2 3 3 2 2 1 3 3 2 2 2 2 2 2 2 3 2 2 3 3 3 2 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 2 1 1 1 2 2 1 2 2 2 3 2 2 2 3 2 3 3 2 2 3 2 3 2 2 2 2 2 2 2 2 2 3 3 4 2
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 0 1 1 1 1 2 1 1 1 2 1 2 1 1 2 2 2 2 2 2 3 3 3 2 2 2 2 3 2 3 3 2 3 2 3 2 2 2 2 4 3 3 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1 2 1 2 1 1 2 2 2 2 2 3 3 3 3 2 2 3 3 2 2 3 4 2 2 1 2 2 3 3 3 4 3 2 2
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 2 2 2 1 2 2 2 2 3 2 3 3 2 3 2 3 3 3 3 3 2 3 2 3 2 3 3 3 2 2 3 3 3 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 1 0 1 1 1 1 1 1 1 1 1 2 2 2 2 1 2 2 3 3 2 3 3 3 3 3 3 2 3 2 2 2 3 3 3 3 3 3 3 4 3 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 2 2 2 2 2 3 1 3 3 3 4 2 3 3 3 3 3 2 3 3 3 3 3 3 3 4 3 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 2 2 2 2 3 2 2 3 2 3 3 4 3 3 3 3 3 2 2 3 3 4 4 3 4 4 3 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 2 1 2 1 2 2 2 3 3 2 3 3 3 3 3 4 3 3 3 3 3 3 3 3 4 3 3 4 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 1 1 1 1 1 1 1 1 2 1 2 2 2 2 1 2 2 2 3 3 3 3 3 4 3 3 3 3 3 3 3 3 4 4 4 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 3 4 3 3 3 4 3 3 4 3 3 3 4 4 3 3 4 3 4
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 2 2 2 3 2 3 2 3 3 3 4 3 3 4 4 3 4 3 4 4 4 4 4 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 2 1 1 1 1 2 1 2 2 2 2 2 3 3 3 4 4 3 4 3 3 3 4 4 4 3 5 5 4 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 0 1 0 1 0 1 1 0 1 1 0 1 1 1 1 1 1 2 2 2 2 2 2 2 3 3 3 4 3 4 4 4 3 4 5 4 5 4 4 5 3
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 3 4 3 3 4 4 4 4 5 5 4 5 5 6 4
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 2 2 2 3 2 3 4 4 4 4 4 4 6 4 5 5 5 5 4
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 2 2 2 2 2 3 3 2 3 4 4 5 6 6 6 6 5 6 5
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 3 2 2 3 2 3 3 5 5 5 6 6 6 6 6 6
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 3 3 3 4 5 6 8 7 7 8 7
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 3 2 3 3 4 5 8 9 11 9 8
1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 3 2 4 5 6 8 13 22
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
55
1 YR Transition matrix : Drug exp, whole population, by percentile
Percentile of drug
expenditure 2009
Percentile
of drug
expenditure
2008
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95
0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 2 2 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 46 4 0 0 0 0 0 0 0 0 0 0 0 0 1 2 2 1 2 1 2 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1 1 2 2 2 3 3 4 5 7 8 8 8 8 6 5 4 3 2 1 1 1 1 1
85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 2 1 2 3 3 4 5 7 8 9 8 8 6 6 4 3 2 2 1 1 0
86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 2 1 2 2 3 4 4 6 8 8 9 9 7 7 5 4 3 2 2 1 1
87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 2 2 3 5 5 7 9 9 10 8 8 5 4 3 2 2 1
88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 2 2 3 4 6 8 9 11 10 9 6 6 4 3 2 2
89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 2 2 3 3 4 6 8 10 12 10 9 7 6 4 2 2
90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 2 2 3 4 6 8 10 11 13 10 7 5 4 2
91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 2 2 3 4 6 8 11 13 12 10 8 6 4
92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 2 3 4 5 8 12 14 14 11 7 5
93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 2 2 3 5 8 12 15 15 12 8
94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 2 3 5 8 12 16 17 13
95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 2 2 4 7 12 18 19
96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 2 3 6 13 20
97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 3 5 11
98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 4
99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1
96 97 98 99
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 1
1 0 0 0
1 1 0 0
1 0 0 1
1 1 0 0
2 1 0 1
1 1 1 1
2 2 1 1
3 2 2 1
5 3 1 1
8 5 2 1
14 7 4 2
24 16 7 2
23 31 16 3
9 24 43 11
1 4 17 67
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
56
1 YR Transition matrix :
Drug exp, population with chronic disease, by percentile
Percentile of drug
expenditure 2009
Percentile
of drug
expenditure
2008
0 1 2 3 4 5 6 7
0 46 0 5 6 4 5 3 3
1 43 0 3 4 6 3 3 2
2 11 11 11 12 8 6 6 3
3 0 17 7 13 11 10 9 7
4 0 14 7 10 11 13 9 5
5 0 9 5 12 10 9 7 7
6 0 9 5 7 8 9 11 8
7 0 7 3 6 9 7 9 10
8 0 6 3 5 5 7 8 9
9 0 3 1 5 5 5 4 8
10 0 4 2 2 4 3 4 6
11 0 4 2 3 1 3 4 6
12 0 3 1 2 3 3 3 5
13 0 3 1 3 2 2 2 4
14 0 3 1 1 1 1 3 2
15 0 2 0 2 1 2 2 2
16 0 3 0 1 1 2 2 2
17 0 2 1 1 1 1 1 1
18 0 0 2 1 1 1 2 1
19 0 0 2 1 1 1 1 1
20 0 0 2 0 1 1 1 1
21 0 0 1 0 1 0 1 1
22 0 0 2 0 1 1 0 0
23 0 0 1 0 0 0 0 0
24 0 0 1 1 0 1 0 1
25 0 0 3 0 0 0 0 0
26 0 0 1 0 0 0 0 0
27 0 0 1 0 0 0 1 0
28 0 0 2 0 0 0 0 0
29 0 0 1 0 0 0 0 0
30 0 0 1 0 0 0 0 0
31 0 0 1 0 1 0 0 0
32 0 0 1 0 0 0 0 0
33 0 0 0 0 0 0 0 0
34 0 0 0 0 0 0 0 0
35 0 0 1 0 0 0 0 0
36 0 0 0 0 0 0 0 0
37 0 0 0 0 0 0 0 0
38 0 0 0 0 0 0 0 0
39 0 0 1 0 0 0 1 0
40 0 0 0 0 0 0 0 0
41 0 0 0 0 0 0 0 0
42 0 0 0 0 0 0 0 0
43 0 0 1 0 0 0 0 0
44 0 0 0 0 0 0 0 0
45 0 0 1 0 0 0 0 0
46 0 0 1 0 0 0 0 0
47 0 0 0 0 0 0 0 0
48 0 0 0 0 0 0 0 0
49 0 0 0 0 0 0 0 0
50 0 0 0 0 0 0 0 0
51 0 0 0 0 0 0 0 0
52 0 0 1 0 0 0 0 0
53 0 0 0 0 0 0 0 0
54 0 0 0 0 0 0 0 0
55 0 0 1 0 0 0 0 0
56 0 0 0 0 0 0 0 0
57 0 0 0 0 0 0 0 0
58 0 0 0 0 0 0 0 0
59 0 0 1 0 0 0 0 0
60 0 0 0 0 0 0 0 0
61 0 0 0 0 0 0 0 0
62 0 0 1 0 0 0 0 0
63 0 0 0 0 0 0 0 0
64 0 0 1 0 0 0 0 0
65 0 0 1 0 0 0 0 0
66 0 0 0 0 0 0 0 0
67 0 0 0 0 0 0 0 0
68 0 0 0 0 0 0 0 0
69 0 0 0 0 0 0 0 0
70 0 0 0 0 0 0 0 0
71 0 0 0 0 0 0 0 0
72 0 0 1 0 0 0 0 0
73 0 0 0 0 0 0 0 0
74 0 0 0 0 0 0 0 0
75 0 0 0 0 0 0 0 0
76 0 0 1 0 0 0 0 0
77 0 0 0 0 0 0 0 0
78 0 0 0 0 0 0 0 0
79 0 0 0 0 0 0 0 0
80 0 0 1 0 0 0 0 0
81 0 0 0 0 0 0 0 0
82 0 0 0 0 0 0 0 0
83 0 0 1 0 0 0 0 0
84 0 0 0 0 0 0 0 0
85 0 0 1 0 0 0 0 0
86 0 0 0 0 0 0 0 0
87 0 0 0 0 0 0 0 0
88 0 0 0 0 0 0 0 0
89 0 0 1 0 0 0 0 0
90 0 0 0 0 0 0 0 0
91 0 0 0 0 0 0 0 0
92 0 0 1 0 0 0 0 0
93 0 0 0 0 0 0 0 0
94 0 0 0 0 0 0 0 0
95 0 0 1 0 0 0 0 0
96 0 0 1 0 0 0 0 0
97 0 0 1 0 0 0 0 0
98 0 0 0 0 0 0 0 0
99 0 0 0 0 0 0 0 0
8
2
1
5
4
4
8
9
8
9
5
7
5
3
4
4
3
3
1
1
2
1
1
1
1
1
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94
2 1 1 1 1 0 1 1 1 0 1 1 1 1 1 0 0 1 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 1 1 0 1 1 1 1 2 1 1 1 1 1 1 1 0 1 1 1 0 1 0 1 1 0 0 1 0 0 0 1 1 0 1 1 0 0 1 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 2 2 1 1 2 1 2 1 1 0 1 1 1 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 3 2 2 1 1 2 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 4 3 2 2 1 1 1 1 1 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 4 5 4 1 2 1 1 2 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 5 3 2 2 2 2 2 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 5 5 3 3 3 1 3 1 0 1 1 0 1 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 5 4 4 4 3 3 2 1 2 1 2 1 1 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 10 6 5 4 4 2 2 2 2 3 1 1 1 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 8 7 6 5 4 4 3 3 2 1 2 1 1 1 0 0 1 1 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 5 7 7 6 5 4 4 3 2 2 2 2 0 1 1 1 1 1 1 1 0 1 0 1 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 5 7 10 7 6 5 5 3 3 3 2 2 2 2 1 1 1 1 1 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 5 5 6 8 6 8 4 5 4 3 2 1 1 1 0 1 2 1 1 0 0 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 6 7 6 6 7 5 5 4 3 4 2 4 2 3 1 1 1 2 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 4 5 4 7 7 5 5 5 5 4 4 3 2 3 1 2 1 1 1 1 1 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 5 4 3 4 6 7 6 5 5 6 3 3 3 1 3 1 2 1 1 1 1 0 0 1 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 4 5 4 4 5 6 6 6 6 8 5 3 3 1 1 1 2 1 1 1 1 1 1 1 0 1 0 1 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 3 2 3 4 4 4 6 6 8 4 6 3 3 2 2 3 2 2 1 1 2 1 1 0 2 1 1 1 0 1 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 2 2 4 5 4 4 4 4 5 8 6 5 5 4 3 2 1 2 2 2 1 1 1 1 1 1 0 1 1 1 0 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 2 2 2 3 4 4 4 6 5 6 5 6 5 3 2 2 3 1 2 2 1 1 1 2 1 0 1 1 1 1 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 2 2 3 3 4 4 5 4 4 5 7 6 6 4 6 4 3 2 2 1 1 1 1 0 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 2 1 1 2 4 4 5 4 8 5 5 5 5 4 3 2 3 2 1 2 3 1 3 1 1 1 2 1 1 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 1 1 1 2 2 3 3 4 4 5 6 6 6 5 4 4 4 3 3 2 2 2 1 2 1 1 0 1 1 1 1 1 1 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 3 1 3 3 2 3 3 5 3 5 5 6 3 5 4 3 3 4 1 2 2 1 1 2 1 1 1 1 1 2 0 1 1 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 2 2 1 2 3 3 4 3 3 5 6 5 4 4 3 6 3 4 3 2 2 1 2 1 1 1 1 0 1 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 1 1 1 1 1 2 3 2 3 2 4 3 5 7 6 4 4 4 3 4 4 2 2 3 3 2 1 2 2 1 0 1 1 1 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 1 1 1 1 2 2 2 1 2 1 3 3 4 5 7 5 4 4 4 4 2 4 3 3 2 3 2 2 1 2 1 1 1 0 1 1 1 1 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 0 1 1 2 3 1 1 2 3 2 5 4 5 4 7 6 5 4 4 3 3 3 3 1 2 2 2 1 1 1 1 1 1 1 0 1 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 1 1 1 0 1 1 2 2 2 3 2 3 4 3 4 5 4 4 6 3 4 4 3 2 2 3 2 2 1 1 2 2 1 1 1 2 1 1 1 0 0 1 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
0 1 1 1 1 1 1 1 2 2 2 2 2 3 2 3 5 6 4 5 5 5 4 4 4 3 3 3 2 1 2 1 1 2 1 2 1 1 1 1 1 1 1 0 0 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 1 1 1 1 2 1 1 3 2 2 2 3 3 4 5 5 5 5 5 4 3 3 2 3 3 3 3 2 1 1 2 1 1 1 1 1 1 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 1 1 1 1 1 1 0 1 2 1 3 3 2 3 5 4 4 6 4 5 5 4 2 4 3 3 3 1 1 2 1 1 2 1 0 1 1 1 1 1 1 1 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 1 1 1 1 1 1 2 2 3 4 3 2 5 3 4 6 4 5 5 4 5 2 3 3 2 3 1 1 1 1 1 1 1 2 0 1 1 1 0 0 1 1 0 0 0 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 1 1 0 0 1 0 1 1 2 1 2 1 3 4 3 3 5 3 4 4 5 3 3 4 3 3 2 1 4 2 1 1 1 3 1 1 1 1 1 1 1 1 1 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 1 0 1 0 1 1 1 1 0 1 1 1 1 2 2 3 2 3 4 4 3 6 5 4 5 4 5 4 3 4 2 2 2 2 1 2 1 0 1 1 1 1 0 1 0 1 1 1 1 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 0 0 0 1 1 1 3 1 1 2 2 2 2 3 3 4 3 5 6 4 3 4 3 4 3 3 3 2 2 2 2 2 2 1 2 1 2 1 0 0 1 1 1 1 1 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 1 0 1 1 3 1 1 1 1 3 1 1 1 3 4 4 4 4 4 5 4 5 5 3 3 3 3 3 3 2 2 1 1 1 2 1 1 1 1 1 0 1 0 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 1 0 1 1 1 1 0 1 1 1 1 1 3 1 1 3 3 4 3 3 3 4 3 5 3 3 4 5 3 2 3 2 2 2 3 1 1 2 1 1 1 1 1 1 0 1 0 1 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 1 0 1 2 0 1 1 1 2 1 3 2 2 3 4 4 4 3 4 3 4 4 4 2 4 3 5 2 1 2 1 2 1 1 1 1 1 1 1 1 1 0 1 1 1 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 1 1 2 2 1 3 3 3 3 3 4 4 4 4 6 4 4 3 3 5 2 2 2 3 3 1 2 1 2 1 1 1 1 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 2 2 3 2 2 3 4 4 4 4 4 4 5 4 3 3 3 3 3 2 2 1 1 1 2 1 2 1 1 0 1 1 1 1 1 1 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 1 1 1 2 1 1 3 1 2 2 3 3 5 3 3 4 3 4 5 5 2 2 3 3 2 2 1 2 1 1 1 1 1 2 1 1 0 1 1 0 1 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 1 0 1 1 1 1 1 2 3 3 3 3 3 3 4 3 4 4 3 3 3 4 3 3 4 2 2 1 3 1 2 1 1 1 1 1 1 1 1 0 0 1 1 1 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 2 0 1 1 1 2 1 2 1 2 2 1 3 3 3 3 4 4 4 5 2 3 2 5 3 3 2 2 2 2 2 1 2 2 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 1 1 3 3 2 2 2 4 3 3 2 3 4 3 3 5 3 5 4 4 3 2 2 2 3 2 2 2 2 1 1 1 0 1 1 1 0 1 1 1 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 2 2 1 1 2 3 3 5 2 3 4 3 4 4 3 4 2 4 3 3 3 2 1 2 1 2 2 2 1 2 1 2 1 1 0 1 1 1 1 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 0 1 1 1 1 1 1 2 3 3 2 2 2 3 3 3 5 2 3 5 4 3 5 3 3 3 2 1 3 3 3 2 2 1 1 1 0 1 1 1 1 1 0 1 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 2 1 1 2 1 1 2 2 3 2 3 2 3 3 3 3 4 4 3 2 3 6 3 4 3 2 3 1 2 2 2 1 1 1 1 1 1 1 1 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 3 2 2 3 3 3 4 3 5 5 3 4 5 4 4 2 3 3 2 2 2 2 2 2 1 2 1 1 1 1 0 1 1 0 0 0 0 1 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 0 1 0 1 1 1 2 2 1 3 2 3 3 3 2 5 3 5 4 4 3 4 5 3 3 2 2 3 2 2 2 1 1 2 2 1 1 1 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 1 1 1 1 2 1 1 3 2 2 2 3 3 2 3 4 3 2 4 4 4 3 4 4 2 3 1 2 3 3 1 1 1 2 2 1 1 1 1 1 0 0 1 0 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 1 0 1 0 1 1 0 1 1 1 3 2 2 1 2 3 5 3 5 3 4 4 5 5 4 3 2 3 3 2 3 1 2 1 2 1 2 1 1 1 1 1 0 1 1 0 1 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 1 1 1 2 1 1 1 1 3 3 4 3 2 3 3 3 5 3 4 2 4 3 3 2 3 2 3 3 1 2 1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 1 1 1 1 2 2 2 2 2 3 3 4 3 3 3 4 6 5 3 2 4 3 3 3 2 1 1 1 1 2 2 1 1 1 2 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 2 2 1 1 3 2 4 4 3 2 5 5 2 4 4 3 3 3 3 2 2 2 2 2 3 3 3 2 2 2 1 1 1 1 1 1 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 1 1 1 1 1 2 2 1 2 2 3 1 4 4 2 3 3 4 4 4 3 3 3 3 2 3 3 3 2 2 2 2 1 2 1 2 1 1 0 0 1 1 1 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 0 1 1 1 1 1 2 1 2 2 3 4 4 3 5 3 4 4 4 3 3 3 3 1 3 1 3 2 2 1 2 2 1 2 2 2 1 1 1 1 0 1 1 0 0 0 1 0 0 0 1 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 1 0 1 1 1 1 3 1 2 1 2 3 1 1 2 3 4 4 3 4 3 3 4 5 4 3 4 3 2 2 1 3 1 1 1 2 0 1 1 1 1 1 1 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 2 2 2 1 3 4 3 2 6 4 4 5 4 5 4 4 2 3 2 3 2 2 2 1 1 1 1 2 1 0 1 1 1 1 1 1 0 1 0 1 0 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 2 1 2 2 3 2 2 3 3 2 4 3 3 4 4 3 3 4 3 3 3 2 1 3 3 2 2 1 1 1 1 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 1 2 1 1 2 3 3 4 4 4 4 3 5 4 3 5 3 2 3 2 4 3 2 2 2 2 1 1 1 1 1 0 0 0 1 1 0 0 0 0 1 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 2 1 2 3 2 3 2 3 4 3 4 4 3 5 5 5 3 3 2 4 2 3 1 1 1 2 2 2 1 1 1 1 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 2 2 3 3 3 3 3 4 3 5 5 3 4 3 4 5 3 4 2 2 2 1 1 1 1 1 1 2 1 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 1 1 1 2 1 2 3 1 2 4 2 3 3 2 5 4 4 5 3 3 2 3 4 3 3 2 2 1 2 2 2 2 1 1 2 1 1 1 1 0 1 1 0 1 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 2 3 2 3 2 2 2 3 4 3 3 5 4 4 2 4 3 3 3 3 3 3 3 2 1 1 2 2 2 1 1 1 1 1 0 1 1 0 1 1 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 2 2 2 3 2 4 4 3 4 4 3 5 3 4 4 3 4 4 3 2 2 3 2 1 2 1 2 1 0 1 1 1 1 1 1 1 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 2 2 3 3 4 3 3 4 4 5 3 4 4 4 3 2 4 3 3 3 2 2 2 2 1 1 2 1 1 1 1 0 1 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 1 1 1 1 1 2 1 1 1 1 1 2 3 1 3 3 5 5 4 5 3 4 4 4 3 5 2 3 4 2 1 1 2 1 1 1 1 1 0 0 1 1 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 1 1 1 2 1 1 0 1 2 2 2 3 2 3 3 2 4 4 3 4 3 3 3 5 3 4 4 2 3 2 3 1 3 2 2 1 1 1 1 1 0 0 1 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 2 2 1 1 2 2 3 2 3 3 4 3 3 4 4 4 5 4 4 3 3 3 3 3 2 1 2 2 2 1 1 1 1 1 1 1 1 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 2 2 1 3 3 3 3 3 3 6 4 4 6 3 3 2 4 4 3 4 2 2 2 1 2 1 1 0 1 1 1 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 1 1 1 1 1 1 2 1 2 3 2 3 2 3 5 4 5 3 6 5 3 4 5 5 3 2 2 1 2 1 2 1 1 1 1 1 1 1 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 2 1 3 2 2 2 5 2 4 4 3 4 4 4 6 4 4 3 2 2 3 1 3 3 1 1 1 2 1 1 1 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 1 1 1 1 1 2 2 1 2 3 3 3 3 3 5 3 7 4 5 4 4 3 3 4 3 2 2 3 3 2 2 1 1 1 1 0 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 1 1 1 0 1 1 1 1 2 1 2 1 2 3 3 4 5 5 5 4 5 4 6 5 2 2 4 3 2 1 2 2 3 2 1 1 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 2 2 1 1 2 2 2 2 2 2 3 3 5 5 5 3 3 5 5 4 3 3 3 2 3 2 2 1 2 1 1 1 1 1 1
0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 1 1 1 1 2 3 3 4 3 3 4 4 5 3 5 6 5 4 3 2 3 3 4 2 2 2 2 1 1 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 1 1 1 1 3 1 2 1 4 4 3 4 4 3 6 6 5 5 6 5 5 3 2 4 3 2 2 1 0 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 1 1 1 1 1 1 2 3 3 2 2 4 5 5 3 5 6 5 5 4 5 4 5 3 2 3 2 2 2 1 1 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 1 2 3 1 1 2 2 3 5 4 5 6 5 5 4 7 5 3 4 4 3 3 3 2 1 2 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 2 3 2 3 2 3 2 4 4 4 4 5 4 5 5 6 4 4 3 3 2 2 2 1 1 1 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 2 1 1 3 1 3 3 3 3 4 3 5 7 6 4 4 5 5 5 5 3 3 2 2 1 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 1 1 1 1 1 1 1 1 3 3 4 2 4 6 7 6 6 8 6 5 4 3 4 3 3 1 2 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 1 0 0 1 1 1 1 2 1 2 3 3 4 5 5 4 6 8 4 7 5 5 4 4 4 3 3 2 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 1 1 2 1 3 2 3 3 4 5 7 5 7 6 7 6 5 5 4 4 3 2 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 1 1 0 0 0 1 1 1 0 1 1 1 1 1 2 3 2 3 3 3 4 5 4 6 5 5 6 5 6 5 4 3 3 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 2 1 3 1 2 3 2 2 2 3 5 7 4 7 7 8 7 7 5 4 4 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 2 1 3 1 5 4 5 4 5 6 9 7 6 8 7 5 4 3 2
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 1 1 2 2 1 1 4 2 4 5 6 7 9 7 11 9 5 4 4 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 2 1 1 1 1 3 2 2 3 3 6 4 5 8 8 9 10 7 5 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 2 2 3 2 3 3 5 7 8 7 11 8 12 8 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 2 2 2 3 4 3 6 9 8 11 13 9 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 1 2 2 2 1 2 4 3 5 7 10 11 13 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 2 2 1 1 1 2 2 3 4 8 10 13 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 1 2 2 3 5 6 15 16
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 2 2 4 4 10
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 1 1 0 1 1 2 4
0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
95
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
0
0
0
1
1
1
1
2
1
3
2
5
7
13
18
22
6
2
0
96 97 98 99
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 1 0 0
0 1 0 0
0 0 0 0
0 0 0 0
0 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 1 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 0 0 0
1 1 0 0
0 0 0 0
0 0 0 0
0 1 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 0 0 0
0 0 0 0
0 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 1 0 0
0 0 0 0
0 1 0 0
0 0 1 0
0 0 1 0
0 0 0 0
1 1 0 0
0 0 0 0
1 1 1 1
1 0 1 0
1 0 0 0
1 1 0 0
0 1 0 0
1 1 0 0
1 1 1 1
2 1 1 0
5 3 1 0
9 3 1 1
12 4 1 1
26 10 2 2
20 34 11 4
3 21 43 17
1 4 24 64
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
57
 To sum-up
March 2015
58
Main findings (1/2) : Concentration
 Concentration of healthcare expenditure
• Polarization : Big spenders concentrate 62% of total medical
spending
• Reimbursement : Big spenders on drugs concentrate 58% of
total drugs spending and 67% of drugs reimbursement
March 2015
59
Main findings (2/2) : Persistence
 Persistence of medical spending
• Total spending
– Significant for people with chronic diseases
– Weak for other people
• By type of care
– Weak for inpatient care spending regardless the health
status of the insuree
– Stronger for pharmaceutical expenditure
March 2015
60
Some issues and questions
 To go further:
• Claims data
– Pros: size of the sample, panel dimension, details on
healthcare spending, some info on health
– Cons: few socieconomic variables
• Age /proximity to death : data preparation (linkage)
• Concentration / persistence :
– detailed analysis of some specific chronic conditions (?)
Should we complete our analysis with results from surveys?
March 2015
61
 Back-up
March 2015
62
Lorenz concentration curve of medical expenditure (2008, 2013)
1
Cumulative share of medical expenditure
2008
Cumulative share of medical expenditure
2013
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
0.4
0.5
0.6
0.7
0.8
0.9
1
63
Lorenz concentration curve of medical expenditure 2013 by age
10% of the
population with
highest spending :
1
Cumulative share of medical
expenditure 2013 (0 to 24 years old)
0.9
Cumulative share of medical
expenditure 2013 (25 to 64 years
old)
Cumulative share of medical
expenditure 2013 (65 years old and
over)
0.8
0.7
0.6
0.5
•
0 to 24 years old :
concentrate more
than 60% of total
spending
•
25 to 64 years old :
concentrate 58% of
total spending
•
65 years old and
over : concentrate
51% of total
spending
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Cumulative share of people from lowest to highest health spending
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
64
Lorenz concentration curve of medical expenditure (2008- 2013), by
health status
1
Cumulative share of medical
expenditure 2008 (without
chronic disease)
0.9
30% of the
population with
chronic disease
with highest
spending :
Cumulative share of medical
expenditure 2008 (with chronic
disease)
0.8
0.7
Cumulative share of medical
expenditure 2013 (without
chronic disease)
0.6
Cumulative share of medical
expenditure 2013 (with chronic
disease)
0.5
•
2008 : concentrate
75% total spending
•
2013 : concentrate
77% of total
spending
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Cumulative share of people from lowest to highest health spending
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
65
Lorenz concentration curve of medical expenditure 2013 by type of
care
1
10% of the
population with
highest inpatient
care spending :
Cumulative share of inpatient
care expenditure 2013
0.9
0.8
Cumulative share of inpatient
public reimbursement 2013
0.7
0.6
0.5
•
concentrate 53%
total hospital
spending
•
concentrate 54% of
total inpatient
reimbursement
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
66
Lorenz concentration curve of medical expenditure 2013 by type of
care
1
0.9
Cumulative share of outpatient care
expenditure 2013
0.8
Cumulative share of outpatient public
reimbursement 2013
0.7
Cumulative share of drugs expenditure 2013
0.6
10% of the
population with
highest outpatient
(drugs) spending :
Cumulative share of drugs public
reimbursement 2013
•
concentrate 49%
(58%) of total
outpatient (drugs)
spending
•
2013 : concentrate
57% (67%) of
outpatient (drugs)
reimbursement
0.5
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
67
 Appendix
March 2015
68
Total current expenditure per capita, US$ at 2005 PPP rates
Total current expenditure/capita, US$ at 2005 PPP rates
8000
7000
6000
United States
5000
Netherlands
4000
Germany
3000
France
2000
United
Kingdom
1000
0
Source : OECD Health Data, 2013
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
69
Average health care expenditure adjusted for cohort effect
Total expenditure
Total expenditure adjusted for cohort effect
2,500 $
2,000 $
1,708 $ 1,708 $
1,907 $ 1,883 $
1,805 $ 1,790 $
1,794 $ 1,783 $
2009
2010
1,890 $
1,851 $
1,905 $
1,853 $
1,500 $
1,000 $
500 $
0$
2008
2011
2012
2013
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
70
Health care expenditure by function of care (2008-2013)
Inpatient care
Outpatient care
Drugs
100%
90%
22%
23%
22%
45%
47%
47%
33%
36%
35%
2008
2009
2010
22%
21%
20%
48%
48%
48%
42%
41%
43%
2011
2012
2013
80%
70%
60%
50%
40%
30%
20%
10%
0%
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
71
Expenditure by type of financing, age and gender in 2013
5,000 $
4,500 $
4,000 $
3,500 $
Private insurance and
out of pocket
3,000 $
2,500 $
2,000 $
1,500 $
1,000 $
Statutory health
insurance (Public)
500 $
0$
Males between 0 Males between
and 24 years old 25 and 64 years
old
Source : SNIIRAM/EGB-PMSI, 2008-20092010-2011-2012-2013
March 2015
Males 65 years
old and over
Females
Females
Females 65 years
between 0 and between 25 and old and over
24 years old
64 years old
72
Average medical spending by expenditure quintile and gender (25 to
64 years old)
7,000 $
6,000 $
5,000 $
4,000 $
quintile 1
quintile 2
quintile 3
3,000 $
quintile 4
quintile 5
2,000 $
1,000 $
0$
2008
2009
2010
2011
2012
2013
Males between 25 and 64 years old
2008
2009
2010
2011
2012
2013
Females between 25 and 64 years old
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
73
Average medical spending by expenditure quintile and gender (0 to
24 years old)
4,000 $
3,500 $
3,000 $
2,500 $
quintile 1
quintile 2
2,000 $
quintile 3
quintile 4
1,500 $
quintile 5
1,000 $
500 $
0$
2008
2009
2010
2011
2012
2013
Males between 0 and 24 years old
2008
2009
2010
2011
2012
2013
Females between 0 and 24 years old
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
74
Average expenditure by age and type of care
2600
2400
2200
2000
Inpatient care
2013
1800
1600
1400
1200
Outpatient care
2013
1000
800
600
Pharmaceuticals
2013
400
200
0
0 to 4 5 to 9 10 to
years years
14
old
old
years
old
15 to
19
years
old
20 to
24
years
old
25 to
29
years
old
30 to
34
years
old
35 to
39
years
old
40 to
44
years
old
45 to
49
years
old
50 to
54
years
old
55 to
59
years
old
60 to
64
years
old
65 to 70 to74 75 to
69
years
79
years
old
years
old
old
80 to
84
years
old
85 to
90
years
old
90
years
old
and
older
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
75
Lorenz concentration curve of medical expenditure (2008- 2013 by
age)
1
Cumulative share of medical expenditure 2013 (65
years old and over)
0.9
0.8
Cumulative share of medical expenditure 2008 (65
years old and over)
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
76
Lorenz concentration curve of medical expenditure (2008- 2013 by
age)
1
Cumulative share of medical expenditure 2013 (25 to
64 years old)
0.9
0.8
Cumulative share of medical expenditure 2008 (25 to
64 years old)
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
77
Correlation coefficients for annual health care expenditure by year
2008
2009
2008
2009
2010
2011
2012
2013
1.00000
0.64392
0.49142
0.45244
0.40691
0.36612
1.00000
0.62022
0.53346
0.47664
0.42353
1.00000
0.59517
0.50733
0.44109
1.00000
0.64875
0.53579
1.00000
0.64107
2010
2011
2012
2013
1.00000
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
78
Correlation coefficients for annual inpatient care expenditure by year
2008
2009
2008
2009
2010
2011
2012
2013
1.00000
0.51588
0.33784
0.30271
0.25807
0.21998
1.00000
0.47942
0.38534
0.32889
0.27841
1.00000
0.42901
0.34094
0.28254
1.00000
0.49681
0.37660
1.00000
0.48287
2010
2011
2012
2013
1.00000
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
79
Correlation coefficients for annual outpatient care expenditure by year
2008
2009
2008
2009
2010
2011
2012
2013
1.00000
0.75502
0.62934
0.54559
0.48366
0.43207
1.00000
0.76238
0.65000
0.57083
0.49464
1.00000
0.77718
0.66037
0.55888
1.00000
0.79222
0.64607
1.00000
0.76164
2010
2011
2012
2013
1.00000
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
80
Correlation coefficients for annual pharmaceuticals expenditure by
year
2008
2009
2008
2009
2010
2011
2012
2013
1.00000
0.84758
0.71828
0.63907
0.56585
0.49076
1.00000
0.84305
0.72846
0.63368
0.53857
1.00000
0.82559
0.70836
0.59774
1.00000
0.83057
0.67360
1.00000
0.78478
2010
2011
2012
2013
1.00000
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
81
Average health care expenditure by year and age
65 years old and over
2008
2009
2010
25 to 64 years old
2011
2012
2013
0 to 24 years old
0
5000
10000
15000
20000
25000
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
82
Total medical expenditure, transition matrices 2008-2009
70
60
59.37
58.87
50
40
37.92
36.99
2009 Q1
%
33.15
2009 Q2
2009 Q3
30
23.81
21.12
25.26
22.48
23.69 22.78
21.96
23.11
2009 Q5
20
10.75
10
11.44
5.56
3.18
9.89
9.74
5.28
11.09
2009 Q4
9.92
5.54
2.57
4.51
0
Q1
Q2
Q3
Q4
Q5
2008
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
83
Total medical expenditure, transition matrices 2008-2010
60
54.72
54.29
50
40
35.18
34.2
2010 Q1
%
31.02
30
24.99
22.07
20.41
2010 Q2
25.88
24.09
20.72
24.26
22.06
2010 Q3
2010 Q4
20
2010 Q5
11.82
10
12.28
7.56
5.93
11.54
10.84
6.46
12.95
10.99
6.55
3.47
5.72
0
Q1
Q2
Q3
Q4
Q5
2008
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
84
Total medical expenditure, transition matrices 2008-2013
60
50
49.34
48.57
40
%
31.19
30
27.55
25.63
24.55
20
21.94
20.29
9.25
10
13.73
12.61
8.26
7.9
24.14
20.48
14.05
13.23
2013 Q1
30.49
15.08
25.72
22.67
2013 Q2
2013 Q3
2013 Q4
2013 Q5
13.15
7.81
4.76
7.62
0
Q1
Q2
Q3
Q4
Q5
2008
Source : SNIIRAM/EGB-PMSI, 2008-2009-2010-2011-2012-2013
March 2015
85