Comment améliorer les mesures d’accessibilité aux soins pour mieux cibler les zones sous-denses ?

Lucas-Gabrielli, Véronique; MANGENEY, Charles-André

doi:10.1016/j.respe.2018.12.061

Cited by 19 publications

(11 citation statements)

References 9 publications

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“…First, following a previously developed methodology [32,43], we estimated a measure of spatial accessibility to hospital care, for MCO and SSR facilities separately at the French Geographic Code scale (FGC, approximately equivalent to the municipality scale). However, all previous French studies that used a similar methodology limited their accessibility measure to non-hospital care services [30][31][32]. The present study originality lies in extending the measure to hospital spatial accessibility, by taking into account the number of beds in MCO and SSR facilities, the car travel time, and the population distribution.…”

Section: Summary Of the Resultsmentioning

confidence: 99%

“…Based on this method, two different spatial indicators have been constructed in France: the localized potential accessibility score developed by the French Research Institute in Health Economic institute (IRDES) at the municipality level in 2011 [30], and at the census block level for the Greater Paris area in 2019 [31]. In 2016, the index of spatial accessibility (ISA) at the census block level was implemented by Gao and al.…”

Section: Introductionmentioning

confidence: 99%

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Potential Hospital Care Accessibility Scores: Association with Healthcare Utilization and Non-Hospital Care Service Accessibility

Gao

Jaffrelot

Deguen

2020

Preprint

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Background: Optimal healthcare access improves people's health status and decreases health inequalities. Many studies demonstrated spatial access importance in health outcomes. Recent studies assessed spatial healthcare access using the enhanced two-step floating catchment area (E2SFCA) method. The aim of this study was to build a hospital facility access indicator at a fine geographic scale and to determine whether there is a complementarity between non-hospital and hospital care accessibility by investigating the length of hospital stays (LOS). Methods: This study focused on the ≥75-year-old population of the Nord administrative region of France. Hospital spatial accessibility was computed with the E2SFCA method, and then the LOS score was calculated from the French national hospital activity and patient discharge database. Linear regression models were used to analyze the relationship between LOS and spatial accessibility to hospital-based care and to the three types of non-hospital care services (general practitioners, physiotherapists, and home-visiting nurses). Results: Overall, there were 19.0 beds in Medical, Surgical and Obstetrics (MCO) facilities and 5.58 beds in Postoperative and Rehabilitation Care facilities (SSR) per 10,000 inhabitants, but with important geographic variations. Accessibility to hospital services was higher for people in large urban areas, despite the dense population and the higher demand. In 2014, the mean LOS scores were 0.26 for MCO and 0.85 for SSR, with a non-homogeneous geographical repartition. Linear regression analysis revealed a strong negative and significant association between hospital and non-hospital care accessibility.Conclusions: This is the first study to measure spatial accessibility to hospital-based cares in France using the E2SFCA method, and the first to investigate the relationship between spatial accessibility to hospital-based care facilities and three types of non-hospital care services and healthcare utilization (LOS). Our findings should help to take decisions about deploying additional beds and to identify the best locations for non-hospital care services. Moreover, they should also help to improve access, and to ensure the best coordination and sustainability of inpatient and outpatient services, in order to better cover the population’s healthcare needs. Other international studies using multiple consensual indicators of healthcare outcomes and accessibility and sophisticated modeling methods should be developed.

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Section: Summary Of the Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Potential Hospital Care Accessibility Scores: Association with Healthcare Utilization and Non-Hospital Care Service Accessibility

Gao

Jaffrelot

Deguen

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Based on this method, two different spatial indicators were constructed in France: the localized potential accessibility score developed by the French Research Institute in Health Economic institute (IRDES) at the municipality level in 2011 [36], and at the census block level for the Greater Paris area in 2019 [37]. In 2016, the index of spatial accessibility (ISA) at the census block level was implemented by Gao and al.…”

Section: Assessing Hospital Care Spatial Accessibility Using the E2sfmentioning

confidence: 99%

“…This analysis French Geographic Code scale (FGC, approximately equivalent to the municipality scale). However, all previous French studies that used a similar methodology limited their accessibility measure to non-hospital care services[36][37][38]. The present study originality lies in extending the measure to hospital spatial accessibility, by taking into account the number of beds in MCO and SSR facilities, the car travel time, and the population distribution.…”

mentioning

confidence: 99%

Potential inpatient hospital care accessibility scores: association with healthcare utilization and non-hospital care service accessibility

Gao¹,

Jaffrelot²,

Deguen³

2020

Preprint

View full text Add to dashboard Cite

Background: Optimal healthcare access improves people's health status and decreases health inequalities. Many studies demonstrated spatial access importance in health outcomes. Recent studies assessed spatial healthcare access using the enhanced two-step floating catchment area (E2SFCA) method. The study aim was to build a hospital facility access indicator at a fine geographic scale and to assess the impact of spatial accessibility to inpatient hospital care and non-hospital care services on the length of hospital stay (LOS). Methods: This study focused on the ≥75-year-old population of the Nord administrative region of France. Hospital spatial accessibility was computed with the E2SFCA method, and then the LOS score was calculated from the French national hospital activity and patient discharge database. Linear regression models were used to analyze the relationship between LOS and spatial accessibility to inpatient hospital care and to three types of non-hospital care services (general practitioners, physiotherapists, and home-visiting nurses). Results: Overall, there were 19.0 beds in Medical, Surgical and Obstetrics (MCO) facilities and 5.58 beds in Postoperative and Rehabilitation Care facilities (SSR) per 10,000 inhabitants, but with important geographic variations. Accessibility to hospital services was higher for people in large urban areas, despite the dense population and the higher demand. In 2014, the mean LOS scores were 0.26 for MCO and 0.85 for SSR, with a non-homogeneous geographical repartition. The linear regression analysis revealed a strong negative and significant association between LOS and non-hospital care accessibility.Conclusions: This is the first study to measure spatial accessibility to inpatient hospital care in France using the E2SFCA method, and the first to investigate the relationship between healthcare utilization (LOS) and spatial accessibility to inpatient hospital care facilities and three types of non-hospital care services. Our findings should help to take decisions about deploying additional beds and to identify the best locations for non-hospital care services. Moreover, they should also help to improve access, and to ensure the best coordination and sustainability of inpatient and outpatient services, in order to better cover the population’s healthcare needs. Other international studies using multiple consensual indicators of healthcare outcomes and accessibility and sophisticated modeling methods should be developed.

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“…Unfortunately, as in almost all countries in the world, there is no equality of access to healthcare in France. 1 This also a concern in large countries like Russia, Australia and Brazil with large rural areas and dispersed rural populations. There are some areas in France where getting access to a health professional is very difficult, and especially to a dentist.…”

Section: Introductionmentioning

confidence: 99%

2019: The Year of Teledentistry in France?

Giraudeau¹,

Roy²,

Malthiéry³

et al. 2019

J Int Soc Telemed eHealth

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In France, access to a dentist for elderly people, disabled people or inmates is limited. A person's access to a dentist decreases by 25% when joining a nursing home. A national report mentioned that 85% of residents in nursing homes didn't have access to a dentist in the past year and 42% in the last 5 years. There are fewer data on disabled people, but 48% of people with disabilities have, at least, one important issue related to oral health. Two examples of teledentistry, the e-DENT project from University Hospital of Montpellier and the TEL-E-DENT project from the public Hospital of Guéret, are presented to describe how teledentistry works in France, the current legal framework, remuneration of teledentistry and the pros and cons of teledentistry in France. 2019 will be crucial for the development of teledentistry as a number official decisions will be made that will influence the implementation of this kind of activity.

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Comment améliorer les mesures d’accessibilité aux soins pour mieux cibler les zones sous-denses ?

Cited by 19 publications

References 9 publications

Potential Hospital Care Accessibility Scores: Association with Healthcare Utilization and Non-Hospital Care Service Accessibility

Potential Hospital Care Accessibility Scores: Association with Healthcare Utilization and Non-Hospital Care Service Accessibility

Potential inpatient hospital care accessibility scores: association with healthcare utilization and non-hospital care service accessibility

2019: The Year of Teledentistry in France?

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