PhD thesis: Trajectories of long-term healthcare utilization and autonomy loss following a stroke in the adult population in France, Europe, and the United States.
Team CRESS: EPIAGEING
Context / Job description:
Stroke is a frequent disorder of the central nervous system. More than a third of patients with stroke have a life expectancy higher than 10 years. Little studies have focused on the long-term healthcare utilization and the autonomy loss following a stroke. Therefore, the thesis will compare trajectories of healthcare utilization and autonomy loss in the decade following a stroke in comparison with the adult population in France, Europe, and the United States. This research will also study the effects of functional parameters measured early after the stroke and the pre-stroke multimorbidity on healthcare utilization and autonomy loss.
Missions – list of activities:
The first objective of this study is to compare the use of care, and more specifically, the possible loss of autonomy (institutionalization in a retirement home and/or need for care at home), during the decade following a stroke, compared with the adult population in France, Europe, and the United States. The hypothesis is that stroke patients have an increased and prolonged need for care and a loss of autonomy compared with the general population.
The second objective is to study the effects of functional parameters measured early after the stroke (for example, loss of autonomy assessed by difficulties in activities of daily living) on the long-term use of care. The hypothesis is that individuals with a more unfavorable early functional profile use care more often and are more often institutionalized or receive home care more regularly during the decade following the stroke than those with a more favorable functional profile.
The third objective is to assess the impact of multimorbidity (i.e., the coexistence of at least two chronic pathologies) prior to the onset of the stroke on this use of care and loss of autonomy at home. We hypothesize that pre-stroke multimorbidity is associated with more frequent use of care and more frequent institutionalization or provision of home care after stroke, compared with people with no pre-stroke multimorbidity.
Profile required: MASTER’S DEGREE IN BIOSTATISTICS, EPIDEMIOLOGY OR PUBLIC HEALTH WITH A GOOD KNOWLEDGE OF STATISTICS
Supervision:
This project will be based on the analysis of three databases: Système National des Données de Santé (SNDS; France; 2015 – ongoing), Survey of Health, Ageing and Retirement in Europe (SHARE; France and Europe; 2004 – ongoing), and Health and Retirement Study (HRS; United States; 1992 – ongoing). The PhD student will be supervised by Dr. Louis Jacob, a physician-researcher in the team. The supervision will be on a weekly basis. The PhD student will also benefit from the expertise of engineers (biostatisticians) and other members of the team.
Duration of employment: 36 months
Starting date: Last quarter of 2025
Activity location: Université paris cité, 10 avenue de verdun, 75010 paris
Condition of employment: 38.30 hours per week. 32 days‘ annual leave and 13 days’ RTT. Partial reimbursement of travel expenses (up to 75%). Inserm Social Action Committee (social, cultural and sports benefits).
Salary: €2,234.94 per month then from 1 January 2026: €2,338.32 per month
Application deadline: May 31th, 2025
Team contact and application details: louis JACOB – louis.jacob@aphp.fr / louis.jacob@inserm.fr
