The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?
| Autor: | Mathias Wargon, Agnès Ricard-Hibon, Enrique Casalino, Romain Hellmann, Donia Bouzid, Alain Michault, Anne-Laure Feral-Pierssens, Axelle Menu, Dominique Brun-Ney, Frédéric Adnet |
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| Přispěvatelé: | Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SAMU 93 [Bobigny], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire éducations et promotion de la santé (LEPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Nord, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre Hospitalier René Dubos [Pontoise], Centre Hospitalier de Saint-Denis [Ile-de-France], Observatoire Regional des Soins Non Programmés [ïle-de-France/Saint-Denis] (ORSNP), Malbec, Odile, Laboratoire Educations et Pratiques de Santé (LEPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Typology
medicine.medical_specialty Healthcare use Health geography [SDV]Life Sciences [q-bio] Distribution (economics) Public Policy Access to care Vulnerable Populations 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Humans 030212 general & internal medicine Retrospective Studies Frequent users business.industry Emergency department Health Policy 030503 health policy & services Public health Public Health Environmental and Occupational Health [SDV] Life Sciences [q-bio] Social deprivation Biostatistics Public aspects of medicine RA1-1270 Emergency Service Hospital 0305 other medical science business Research Article Demography |
| Zdroj: | BMC Public Health, Vol 21, Iss 1, Pp 1-12 (2021) BMC Public Health BMC Public Health, 2021, 21 (1), pp.1689. ⟨10.1186/s12889-021-11682-z⟩ BMC Public Health, BioMed Central, 2021, 21 (1), pp.1689. ⟨10.1186/s12889-021-11682-z⟩ |
| ISSN: | 1471-2458 |
| Popis: | Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region. Methods We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon. Results FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities. Conclusion FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories. |
| Databáze: | OpenAIRE |
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