6533b86cfe1ef96bd12c873a

RESEARCH PRODUCT

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

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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 flow to different geographical and historical divisions in Burgundy and in nine other test regions.Main results : The cartography of hospital flow in Burgundy and for each test region showed that the choices made by patients were often coherent with regard to the limits that we used. Our results indicate that regional administrative boundaries do not always create homogeneous territories. For each test region, invisible boundaries appear. They stem from historical sedimentation and were shaped by numerous geographic dynamics.Discussion/ConclusionGeography makes it easier to understand hospital flow, which escapes the logic of current regional administrative planning. Now, with the creation of new super-regions, geography appears to be an essential tool to establish more pragmatic healthcare coverage.