0000000000505113
AUTHOR
Pierre Metral
Séroconversion toxoplasmique chez la femme enceinte
Resume Introduction La France possede depuis 1992 un programme de prevention de la toxoplasmose reposant sur la detection serologique des infections en cours de grossesse. En l’absence de consensus, les seroconversions depistees sont prises en charge de facon variable selon les centres. Objectif Decrire les pratiques des centres experts francais et faire des propositions pour reduire leur heterogeneite. Methode Enquete postale par questionnaire aupres des centres de parasitologie francais de reference pour la prise en charge des seroconversions toxoplasmiques en cours de grossesse. Resultats La totalite des 30 centres interroges ont repondu. Cinq d’entre eux ne font pas de recommandations t…
Modeling of medical activity heterogenity to improve the hospital management by diagnosis-related groups
Since the early 1980s healthcare systems in the industrialized nations have been undergoing radical reform aimed at curbing overspending of hospital expenditure. After a discussion of the limits of a prospective payment due to heterogeneity of costs within DRGs, we demonstrate the ability of anovel statistical model to identify high cost patients. We derive from this statistical model an economic heuristic in order to account for high cost patients in budget allocation and a Structural and Contingent method is proposed as a budgeting tool. Economic analysis based on this modeling of DRG heterogeneity further reveals the potential for improving the equity and the efficiency of the prospectiv…