Évolutions de la prise en charge hospitalière des accidents vasculaires cérébraux en court séjour et en soins de suite et de réadaptation entre 2007 et 2009 en France

Peretti, Christine de; Nicolau, J.; Tuppin, Philippe; Schnitzler, A.

doi:10.1016/j.lpm.2012.01.032

Cited by 24 publications

(9 citation statements)

References 13 publications

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“…The increase concerning the 36–55 years age group for ischemic stroke, notably in men, is in keeping with recent data, whether from different population registries or from medico-administrative data [ 7 ], and with trends observed worldwide [ 1 , 18 , 19 ]. This increase is certainly multifactorial and raises the problem of uncontrolled or increasing risk factors in this population.…”

Section: Discussionsupporting

confidence: 83%

“…We thus focused a part of our analysis on this indicator of performance of the healthcare system, especially since this type of analysis is becoming more widespread with the growing use of medico-administrative data [ 26 – 28 ]. The reduced in-hospital mortality observed for hospital stays overall corresponds to observations of a French study, which reported that the proportion of intra-hospital deaths during the first hospital stay for stroke had fallen significantly by 0.5 percentage points between 2007 and 2009 [ 7 ]. These observations could be related to the better reactivity of hospital emergency departments and the earlier arrival of patients.…”

Section: Discussionsupporting

confidence: 73%

“…This situation is probably related to the greater efficacy of prevention messages and the earlier involvement of the healthcare system. A study published in 2012 [ 7 ] underlined the interest of the PMSI-MCO to elaborate and analyze hospital and follow-up care trajectories. The study highlighted the growing importance of stroke units between 2007 and 2009 and concluded that the overall management of stroke was more effective, with a reduction of the in-hospitality mortality.…”

Section: Introductionmentioning

confidence: 99%

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The use of national administrative data to describe the spatial distribution of in-hospital mortality following stroke in France, 2008–2011

et al. 2016

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Background: In the context of implementing the National Stroke Plan in France, a spatial approach was used to measure inequalities in this disease. Using the national PMSI-MCO databases, we analyzed the in-hospital prevalence of stroke and established a map of in-hospital mortality rates with regard to the socio-demographic structure of the country. Methods:The principal characteristics of patients identified according to ICD10 codes relative to stroke (in accordance with earlier validation work) were studied. A map of standardized mortality rates at the level of PMSI geographic codes was established. An exploratory analysis (principal component analysis followed by ascending hierarchical classification) using INSEE socio-economic data and mortality rates was also carried out to identify different area profiles.Results: Between 2008 and 2011, the number of stroke patients increased by 3.85 %, notably for ischemic stroke in the 36-55 years age group (60 % of men). Over the same period, in-hospital mortality fell, and the map of standardized rates illustrated the diagonal of high mortality extending from the north-east to the south-west of the country. The most severely affected areas were also those with the least favorable socio-professional indicators. Conclusions:The PMSI-MCO database is a major source of data on the health status of the population. It can be used for the area-by-area observation of the performance of certain healthcare indicators, such as in-hospital mortality, or to follow the implementation of the National Stroke Plan. Our study showed the interplay between social and demographic factors and stroke-related in-hospital mortality. The map derived from the results of the exploratory analysis illustrated a variety of areas where social difficulties, aging and high mortality seemed to meet. The study raises questions about access to neuro-vascular care in isolated areas and in those in demographic decline. Telemedicine appears to be the solution favored by decision makers. The aging of the population managed for stroke must not mask the growing incidence in younger people, which raises questions about the development of classical (smoking, hypertension) or new (drug abuse) risk factors.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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The use of national administrative data to describe the spatial distribution of in-hospital mortality following stroke in France, 2008–2011

et al. 2016

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“…In this study, the CCI score was independently associated with the lengths of stay after hemorrhagic and ischemic stroke. The mean length of stay for stroke patients using medical facilities was 5.3 days in the United States, 7 days in Canada, and 12.7 days in France 11 , 12 , 13 ) . However, the average length of stay in Korea is longer than in these other countries.…”

Section: Discussionmentioning

confidence: 99%

Analysis of variation in length of stay (LOS) after ischemic and hemorrhagic stroke using the Charlson Comorbidity Index (CCI)

Lim

Cheon

2015

J Phys Ther Sci

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[Purpose] The purpose of this study was to understand factors present at baseline that affect outcome and healthcare utilization post-stroke. We investigated the association between the Charlson Comorbidity Index (CCI) score and functional outcome (length of stay) after hemorrhagic and ischemic stroke. [Subjects and Methods] Data from the Korean National Hospital Discharge In-depth Injury Survey for 6 years, from 2005 to 2010, were used. The t-test and analysis of variance were carried out to compare average differences in the length of stay with the general characteristics in accordance with CCI. Multiple regression analysis was carried out using dummy variables to look at factors affecting stroke patients’ length of stay. [Results] Independent variables with significant relationships with the log-transformed length of stay included gender, type of insurance, the size of city of residence, the number of beds in the hospital, the location of the medical institution, hospitalization path, receipt of physical therapy, treatment involving brain surgery, death, the type of stroke, and CCI. [Conclusion] The results of the present study suggests that CCI independently influences the length of stay after ischemic and hemorrhagic stroke and that variables with significant relationships with the log-transformed length of stay need to be continuously managed.

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“…La première UNV a été créée en France en 1979. L'article de Peretti et al [2] montre que 30 ans plus tard, seulement un patient sur deux est admis dans un établissement ayant une UNV. Cent-quarante UNV sont prévues dans le « plan national AVC 2010-2014 » [3].…”

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Une filière de soins animée et coordonnée pour les patients victimes d’accidents vasculaires cérébraux

Woimant

Léger

2012

La Presse Médicale

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Évolutions de la prise en charge hospitalière des accidents vasculaires cérébraux en court séjour et en soins de suite et de réadaptation entre 2007 et 2009 en France

Cited by 24 publications

References 13 publications

The use of national administrative data to describe the spatial distribution of in-hospital mortality following stroke in France, 2008–2011

The use of national administrative data to describe the spatial distribution of in-hospital mortality following stroke in France, 2008–2011

Analysis of variation in length of stay (LOS) after ischemic and hemorrhagic stroke using the Charlson Comorbidity Index (CCI)

Une filière de soins animée et coordonnée pour les patients victimes d’accidents vasculaires cérébraux

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