IRDES Newsletter

Coronavirus Containment Policies and Impact on the Population's Mental Health

As part of the implementation of containment policies to fight the Covid-19 epidemic, IRDES is the French partner of an international survey, COCLICO, launched on 3 April 2020 in the general population. It aims to assess the impact of these policies on mental health as well as associated factors such as conditions of vulnerability to the virus, the socio-economic situation, the material conditions of containment, etc.
COCLICO survey: specific section for people living with a chronic illness or a disability
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Covid-19-France's Response to the Coronavirus Pandemic

Zeynep Or and Coralie Gandré (IRDES), together with Isabelle Durand-Zaleski (AP-HP Santé Publique Hôpital Henri Mondor) and Monika Steffen (Pacte, University of Grenoble), contribute as members of the European Health Policy Group (EHPG) to the Cambridge Core blog for France.

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Wennberg International Collaborative (WIC)

IRDES is now an institutional member of the Wennberg International Collaborative, a research network dedicated to improving healthcare based on the examination of territorial and organisational variations in the supply and use of care as well as its quality and efficiency.

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Atlas of Mental Health in France
IN FRENCH

Coldefy M., Gandré C. (IRDES)
IRDES Book, Atlas series, 7, May 2020

In France, mental disorders are associated with major challenges in terms of care management in a field undergoing rapid change. Still often focused solely on care, the follow-up of people suffering from mental disorders is nevertheless oriented towards recovery and the social, professional and civic inclusion of people. Involving many stakeholders in the health and medico-social sectors who must cooperate within the framework of territorial mental health projects, this follow-up is still difficult to characterise on a national scale, based on the existing information system (...). In this context, the Atlas of Mental Health in France provides an unprecedented picture of both the care provided and the healthcare supply available in the territory based on existing information systems.

English-French Glossary of Health Economic Terms

IRDES Books, Glossary series, 6, September 2019

This new edition of the English-French Glossary of terms, concepts and acronyms in health economics follows the publication of the French-English Glossary.
Both editions are updated regularly.

How can the Methods for Measuring the Spatial Inequalities of Access to General Practitioners be Improved? Illustration in Ile-de-France

Lucas-Gabrielli V. (IRDES), Mangeney C. (ORS Ile-de-France)
Issues in Health Economics (Questions d'économie de la santé), 246, January 2020

Research on the spatial inequalities of access to primary healthcare, based on « floating density » type indicators, has made it possible to transcend the limits of the traditional indicators of density and distance. Local potential accessibility (LPA) – which takes into account the distances between municipalities by car, the availability of care, and the age structure of the population – is an adaptation of this type of method to the French context, which means that pre-established conclusions can be reconsidered. To further improve the measurement, the indicator has been refined in various ways in this methodological study.
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Access to State Medical Aid by Undocumented Immigrants in France: First Findings of the 'Premiers Pas' Survey

Jusot F. (Paris-Dauphine University, PSL, Leda-Legos, IRDES), Dourgnon P. (IRDES), Wittwer J. (University of Bordeaux, Bordeaux Population Health (INSERM U1219), EMOS Team), Sarhiri J. (IRDES)
Issues in Health Economics (Questions d'économie de la santé), 245, November 2019

France decided many years ago to grant access to healthcare services for undocumented immigrants when it introduced a scheme known as Aide Médicale Gratuite (Free Medical Care) and, since 2000, the State Medical Aid (AME) scheme. The existence of this kind of scheme does not guarantee, on its own, that all of the eligible persons neither access the scheme, nor make use of it. In this paper we analysed access to State Medical Aid and its determinants based on data from the 'Premiers Pas' survey, which was carried out in 2019 on a sample of undocumented immigrants. Only 51% of those eligible actually take up State Medical Aid.
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A Study of Undocumented Immigrants' Access to Health Coverage and Care in France: The 'Premiers Pas' Survey

Dourgnon P. (IRDES), Guillaume S. (IRDES), Jusot F. (Paris-Dauphine University, PSL, Leda-Legos, IRDES), Wittwer J. (University of Bordeaux, Bordeaux Population Health (INSERM U1219), EMOS Team)
Issues in Health Economics (Questions d'économie de la santé), 244, November 2019

Very little is known about State Medical Aid (Aide Médicale de l'état, AME), the health insurance programme for undocumented immigrants in France. What are the social, economic, and health characteristics of undocumented immigrants covered by State Medical Aid? Who are those who do not take up and for what reasons? Does State Medical Aid (AME) provide insured individuals with effective access to healthcare services? Recent debate about a possible reform of State Medical Aid was only based on scant and sometimes biased information.
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Providing Healthcare Coverage to Undocumented Immigrants in France. What We Know, and What We Don't, about State Medical Aid (AME)

Wittwer J. (University of Bordeaux, Bordeaux Population Health (INSERM U1219), EMOS Team), Raynaud D. (IRDES), Dourgnon P. (IRDES), Jusot F. (Paris-Dauphine University, PSL, Leda-Legos, IRDES)
Issues in Health Economics (Questions d'économie de la santé), 243, November 2019

Since its implementation in 2000, State Medical Aid (Aide Médicale de l'état, AME), a public health insurance programme for undocumented immigrants, has provoked intense debate. Some underscore the need to protect a vulnerable population and the universality of the right to healthcare coverage in France, while others perceive the scheme as an abuse of the social protection system that encourages illegal immigration. In a context of severe financial constraints on the healthcare system, issues relating to the legitimacy, cost, and effectiveness of State Medical Aid (AME) are becoming pressing. However, information about illegal immigrants access and use of the scheme has for a long time been incomplete. The ‘Premiers Pas' project, conducted by the University of Bordeaux and IRDES, aimed to study undocumented immigrants' access to State Medical Aid and healthcare utilisation in France.
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The Influence of Patient Care Management on the Length of Hospital Stay for Stroke

Nestrigue C., Bricard D., Com-Ruelle L., Debals-Gonthier M. (IRDES)
Issues in Health Economics (Questions d'économie de la santé), 242, June 2019

Patients' care pathways were analysed in this study through the link between the first phase of treatment of a stroke in an acute care hospital and downstream care in other health facilities, medical and social care facilities, or ambulatory healthcare structures. More precisely, we observed the variability of the length of the first hospital episode for a stroke in acute care. The nature of the stroke and the general health status of the patients played a key role, as well as the medical treatment, particularly treatment in stroke units (SU). But, beyond the criteria of clinical good practice, the availability of downstream care, particularly follow-up and rehabilitation care, made it possible to reduce the length of hospital stay while minimising stroke victims' inability to recover.

The Risk Factors in Patients Hospitalized for a First Episode of Stroke in France

Léandre C. (IRDES, AP-HP), Com-Ruelle L. (IRDES)
Issues in Health Economics (Questions d'économie de la santé), 240, March 2019

The frequency of strokes in France and the significant consequences in terms of the fatality rate and disability linked to sequelae have made them a true public health concern. In order to improve the treatment of patients, the 2010-2014 Stroke National Action Plan (Plan d'actions national AVC) recommends, in particular, the development of stroke prevention strategies by deploying preventive measures and screening initiatives for checking risk factors that are causes of stroke. Although the risk factors have been clearly identified by clinicians and calculated in certain sample studies, what is the state of play at the national and regional levels?
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Sequence Analysis and Determinants of Care Pathways in the Post-acute Phase of a Stroke
IN FRENCH

Nestrigue C., Com-Ruelle L., Bricard D. (IRDES)
Working Paper (Document de travail), 82, October 2019

The complexity of health care pathways for victims of a first episode of stroke during the three months following discharge from the acute hospital phase is analyzed using medico-administrative data from the National Health Data System (Système national des données de santé, SNDS). The study is based on an original method of constructing individual pathways by sequence analysis based on the identification and chronology of treatment sites, either in hospitals or in ambulatory care and, for ambulatory care, on the types of health professionals involved. The determinants of pathways are analyzed by measuring the specific effects of age and gender, clinical characteristics, medical treatment and local health care supply.
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Improving Health and Social Care for the Elderly: The Impact of Personalized Health Plans on Health Care Pathways
IN FRENCH

Penneau A., Bricard D., Or Z. (IRDES)
Working Paper (Document de travail), 81, July 2019

Warranting the adequate provision of health and social care for elderly people is a major public policy issue. As part of the experimentations, Healthcare pathways for seniors (Paerpa), launched in 2014 with the aim of improving care for frail elderly people, a coordination tool named "Personalized Health Plan" (Plan personnalisé de santé - PPS) was proposed. The PPS is an innovative plan that aims to improve the coordination and continuity of health and social care, and thus prevent the loss of autonomy, avoid inappropriate hospitalizations and polypharmacy. Our study aims to evaluate the impact of realizing a PPS on healthcare pathways by examining the evolution of healthcare consumption and quality of care of elderly patients benefiting from it.
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Accessibility to General Practitioners in the Ile-de-France Region: A Methodology for measuring Infra-communal Inequalities
IN FRENCH

Lucas-Gabrielli V. (IRDES), Mangeney C. (ORS Île-de-France)
Working Paper (Document de travail), 80, July 2019

One of the major challenges of health policies in developed countries is to ensure that the population has equal access to health care on the territory. As many OECD countries, France faces problems of scarcity and unequal distribution of health human resources. The French public authorities are trying to encourage health professionals to work in areas qualified as underserved in health care. The identification of these areas becomes a major challenge because "the greatest obstacle to the use of the concept of accessibility is the difficulty of translating it into operational indicators".
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2017 Complementary Health Insurance Survey (PSCE)
IN FRENCH

Perronnin M. (IRDES)
Report (Rapport), 572, November 2019

This new edition of the Employer-provided Complementary Health Insurance Survey (PSCE), conducted in 2017, is part of the generalisation of employer-provided complementary health insurance in France, following the implementation of the 2013 National Interprofessional Agreement (ANI, Accord national interprofessionnel), with which private sector employers had to comply before 1 January 2016. The data from the PSCE 2017 survey, collected from establishments and their employees, thus make it possible to draw up an overview of employer-provided complementary health insurance, to assess the effect of the ANI on the provision of health coverage and to describe the provision of provident benefits.
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Health Care Expenditure and Out-of-Pocket Payments for Persons with Disabilities before and after the Age of 60
IN FRENCH

Penneau A., Pichetti S. and Espagnacq M. (IRDES)
Report (Rapport), 571, September 2019

Disability situations entail additional costs for the households concerned. Healthcare costs - medical care and part of the technical aids represent one of the main expenditure items for people with disabilities. This report aims to give a clear picture of the health care delivery for these people before and after the age of 60.
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Stadnick N.A., Aarons G.A., Blake L., Brookman-Frazee L.I., Dourgnon P., Engell T., Jusot F., et al. BMC Proceedings, vol 14, suppl 2, 2020/04, 1-12.

Gandré C., Coldefy M. International Journal of Environmental Research and Public Health, 2020/05, vol. 17, n° 10, 1-17.

Or Z., Pierre A. In Is Two-Tier Health Care the Future? Flood C. M., Thomas B. (Eds). Ottawa : PUO, 2020/04, 237-266.

Heinzlef O., Molinier G., Van Hille B., Radoszycki L., Dourgnon P., Longin J. PharmacoEconomics Open. On line: 2020/02/12, 1-11

Adherence to Medical Follow-up Recommendations Reduces Hospital Admissions: Evidence from Diabetic Patients in France

Bussière C., Sirven N., Rapp T., Sevilla-Dedieu C., Health Economics. On line : 21/01/2020, 1-15.
(Catégorie 1 - CNRS) - (Cat. A - Hcéres)

Gautier S., Bourgueil Y. European Journal of Public Health, vol 29, suppl. 4, 2019/11.
(Catégorie 3 – CNRS) – (Cat. B – Hcéres)

Gandré C., Rosenberg S., Coldefy M., Or Z., Health Policy, en ligne le 19/08/2019, 1.7.
(Catégorie 2 - CNRS) - (Cat. A - Hcéres)

Bas A.C., Azogui-Lévy S. Community Dentistry and Oral Epidemiology. 2019/08, vol. 47, n° 4, 291-298.

Lescher M., Sirven N., Revue d'économie politique. Les 39^es Journées des économistes français de la santé, vol. 129, n° 4, 2019/07-08, 525-551.
(Catégorie 2 – CNRS) – (Cat. A – Hcéres)

Flynn E., Pinilla-Rocancio M., Gómez-Carrillo de Castro M. Avec la collaboration de Wooley S., Coldefy M., Podevin M., et al., Galway : National University of Ireland, 2019/04, 135p.

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... Paul Dourgnon, Florence Jusot and Jérôme Wittwer, following the publication of the three Issues in Health Economics (243, 244, 245), November 2019: Providing Healthcare Coverage to Undocumented Immigrants in France. What We Know, and What We Don't, about State Medical Aid (AME), A Study of Undocumented Immigrants' Access to Health Coverage and Care in France: The 'Premiers Pas' Survey, Access to State Medical Aid by Undocumented Immigrants in France: First Findings of the "Premiers Pas" Survey

• How was the idea for this "Premiers Pas Survey" conceived?
• What does the survey of persons eligible for State Medical Aid tell us?
  
• Could we assume, however, that this level of access is low because a part of the immigrants, in poor health, in need of care, takes up with State Medical Aid, while the rest of this population is finally young and healthy?

Read the interview