Hospitalizations for Stroke in France During the COVID-19 Pandemic Before, During, and After the National Lockdown.

Background and Purpose: In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19 infection, before, during, and after the nationwide lockdown (January to June 2020). Methods: All patients admitted for acute stroke/TIA into all public and private hospitals of the 2 study regions were included. Data wer…

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

International audience; 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 …

Classification of hospital pathways in the management of cancer: application to lung cancer in the region of burgundy.

Abstract Context : The evaluation of national cancer plans is an important aspect of their implementation. For this evaluation, the principal actors in the field (doctors, nurses, etc.) as well as decision-makers must have access to information that is reliable, synthetic and easy to interpret, and which reflects the implementation process in the field. We propose here a methodology to make this type of information available in the context of reducing inequalities with regard to access to healthcare for patients with lung cancer in the region of Burgundy. Methods : We used the national medico-administrative DRG-type database, which gathers together all hospital stays. By using this database…

Prise en charge des pathologies cardiovasculaires, pulmonaires et traumatiques : lieux d’hospitalisation et flux des patients domiciliés en Autunois et Morvan

Introduction Meme si l’egal acces aux soins est prone par la loi HPST, depuis cinq ans, deux millions de Francais supplementaires ont ete touches par la desertification medicale et les inegalites entre les territoires ne cessent d’augmenter. Pour faire face a cet enjeu, un pacte « territoire sante » a ete presente par le ministre charge de la sante qui necessite d’identifier les bassins de desserte des hopitaux et les flux des patients. L’objectif de cette etude est de localiser les lieux d’hospitalisation et de decrire les flux des patients en prenant pour exemple des zones mal desservies telles que celles de l’Autunois et du Morvan. Materiels et methodes Cette etude concernait l’ensemble …

Depression and obesity, data from a national administrative database study: Geographic evidence for an epidemiological overlap

BackgroundDepression and obesity are two major conditions with both psychological and somatic burdens. Some data suggest strong connections between depression and obesity and more particularly associated prevalence of both disorders. However, little is known about the geographical distribution of these two diseases. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory.MethodsData for 5,627 geographic codes for metropolitan France were collected from the two national hospital databases (PMSI-MCO and RIM-P) for the year 2016. We identified people who were depressed, obese or both registered in the two public medic…

Accessibilité de la maternité la plus proche en Bourgogne, comparaison de deux méthodes de calcul d’itinéraires

Dépistage du cancer du sein dans treize départements français

Resume Objectif L’objectif de ce travail etait de decrire la participation au depistage organise (DO) et la demarche de detection par mammographie individuelle (MI) en 2010–2011 dans 13 departements francais. Methodes L’analyse a porte sur les donnees de 622 382 femmes âgees de 51 a 74 ans invitees au DO du cancer du sein en 2010–2011. Le type de mammographie realisee a ete etudie selon l’âge, le regime d’Assurance maladie, la ruralite et le niveau socio-economique du lieu de residence. L’analyse a egalement permis de cartographier et d’analyser les zones etudiees en fonction de la defavorisation socio-economique et de la participation au depistage. Resultats Une mammographie de DO ou indiv…

Hospitalization for self-harm during the early months of the Covid-19 pandemic in France: a nationwide study

ABSTRACTIntroductionLittle is known to date about the impact of Covid-19 pandemic on self-harm incidence.MethodsThe number of hospitalizations for self-harm in France (mainland and overseas) from January to August 2020 (which includes the first confinement from March 17th to May 11th) was compared to the same period in 2019-2017. Hospital data with the ICD-10 codes X60-84 were extracted from the national administrative database (PMSI).ResultsThere were 53,583 hospitalizations for self-harm in France between January and August 2020. Compared to the same period in 2019, this represents an overall 8.5% decrease. This decrease started the first week of the confinement and the number of hospital…

European transnational ecological deprivation index and participation in population-based breast cancer screening programmes in France.

Abstract Background We investigated factors explaining low breast cancer screening programme (BCSP) attendance taking into account a European transnational ecological Deprivation Index. Patients and methods Data of 13,565 women aged 51–74 years old invited to attend an organised mammography screening session between 2010 and 2011 in thirteen French departments were randomly selected. Information on the women's participation in BCSP, their individual characteristics and the characteristics of their area of residence were recorded and analysed in a multilevel model. Results Between 2010 and 2012, 7121 (52.5%) women of the studied population had their mammography examination after they receive…

Hémorragie sévère du post-partum et distance domicile-hôpital : étude en population à partir des données hospitalières

Introduction Afin de diminuer la mortalite et morbidite severe maternelle, une attention particuliere merite d’etre portee a l’hemorragie severe du post-partum (HPP), notamment a la recherche de nouveaux facteurs de risque. L’objectif de l’etude etait d’estimer le risque d’HPP severe lie a la distance entre le domicile et le service d’obstetrique et de decrire les facteurs de risque de l’HPP severe identifies par le Programme de medicalisation des systemes d’information (PMSI). Methodes Une cohorte retrospective en population a ete realisee a partir de la base nationale du PMSI de 2011, via le code Z37. La variable d’interet etait l’HPP severe par atonie uterine identifiee par le code corre…

Analyse géographique de la prévalence de l’obésité et de la dépression à partir des bases du Programme de médicalisation des systèmes d’information et du RIM-P

Introduction La prise en charge de l’obesite et de la depression represente un poids consequent et en augmentation pour le systeme de soins. Plusieurs etudes ont montre que ces deux pathologies partagent des mecanismes physiopathologiques communs. Par ailleurs, aux Etats-Unis, la repartition spatiale des zones de forte prevalence des deux pathologies presente des similitudes. Cette repartition etant meconnue en France, nous avons cherche si les deux pathologies touchaient les memes territoires. Methodes Nous avons identifie dans le PMSI-MCO les patients presentant un diagnostic d’obesite ou un diagnostic principal de depression. A partir du RIM-P, nous avons identifie les patients presentan…

Hospitalization for self-harm during the early months of the COVID-19 pandemic in France: A nationwide retrospective observational cohort study

ABSTRACT Background Little is known to date about the impact of COVID-19 pandemic on self-harm. Methods The number of hospitalizations for self-harm (ICD-10 codes X60-X84) in France from 1st January to 31st August 2020 (including a two-month confinement) was compared to the same periods in 2017–2019. Statistical methods comprised Poisson regression, Cox regression and Student's t-test, plus Spearman's correlation test relating to spatial analysis of hospitalizations. Outcomes There were 53,583 self-harm hospitalizations in France during January to August 2020. Compared to the same period in 2019, this represents an overall 8·5% decrease (Relative Risk [95% Confidence Interval] = 0·91 [0·90–…

Apport de l’utilisation des données médico-administratives pour une politique de santé territorialisée : l’exemple de la mortalité hospitalière des accidents vasculaires cérébraux, 2008–2011

Introduction La mise en œuvre du Plan national AVC prevoit l’utilisation des grandes bases de donnees medico-administratives pour etablir et suivre certains indicateurs de prise en charge des personnes victimes d’AVC. A partir des bases nationales du PMSI-MCO 2008–2011, nous avons etabli une analyse de la prevalence hospitaliere des AVC ischemiques et hemorragiques ainsi qu’une cartographie des taux de mortalite hospitaliere. Methodes Les principales caracteristiques des patients identifies selon une liste de codes CIM10 relatifs a un AVC (retenus suite a des travaux de validation anterieurs) ont ete etudiees. Une cartographie des taux de mortalite standardises a ete effectuee a l’echelle d…

Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study

International audience; Background: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks ofgestational age (GA).Methods: This nation-wide population-based study used the French medico-administrative database to assess thefollowing outcomes in singleton live-born infants (32–43 weeks) without congenital anomalies (year 2011): neonatalhospitalization (day of life 1 – 28), post-neonatal hospitalization (day of life 29 – 365), and 1-year in-hospital mortalityrates. Marginal models and negative binomial regressions were used.Results: The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks,the lower the…

Hospitalizations of patients in Burgundy and in nine other french regions, spatial analysis of interregional flows from french hospital claims data

Introduction / presentation of the context : The creation of ARS (Regional Healthcare Agencies) was accompanied by the regionalized organization of healthcare. Even though the administrative procedures for dividing the country into areas for healthcare coverage are well known, we propose a geographic analysis of the reasons why patients attend one hospital rather than another, which seem to escape the logic used by the authorities.Methods employed and sources of data : Using the PMSI-MCO, we studied the flow of patients living in one region to hospitals in other regions according to ten reasons for visiting hospitals. The analysis was completed by a cartographic analysis, which related the …

Prevalence of patients hospitalised for male breast cancer in France using the French nationwide hospital administrative database

BACKGROUND Breast cancer (BC) in men is a rare and neglected disease representing <1% of all cancers in men and only 1% of all incident BC in western countries. OBJECTIVE This study aimed to describe trends in the prevalence of patients hospitalised for male BC in France from 2009 to 2013, using the national administrative database (PMSI). METHODS We included all men aged ≥18 admitted to hospital for BC during this period and estimated the prevalence of male breast cancer hospitalised in France over 5 years. We also describe clinical characteristics and treatments in men with surgery for BC over the 5-year period of the study. RESULTS The prevalence of patients hospitalised for BC significa…