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Allaert F.A.,CEN Nutriment | Quantin C.,Service de biostatistique et dinformatique medicale DIM | Quantin C.,University of Burgundy
Journal d'Economie Medicale | Year: 2012

Medical tele-expertise, that is to say the expertise provided to a physician by another physician located at a distance through a telematic system is a medical act and must be recognized as such for its role in improving the quality of care. This article analyzes the respective liabilities of the physicians involved in telexpertise , the modalities of the payment of their fees and therefore the conventional or contractual framework of the daily medical tele-assistance practice.

Pierron A.,Service de biostatistique et dinformatique medicale DIM | Revert M.,Ecole de sages femmes Saint Antoine | Revert M.,University of Versailles | Goueslard K.,Ecole de sages femmes | And 6 more authors.
Revue d'Epidemiologie et de Sante Publique | Year: 2015

Background: In order to assess public health policies for the perinatal period, routinely produced indicators are needed for the whole population. In France, these indicators are used to compare the national public health policy with those of other European countries. French administrative and medical data (PMSI) are straightforward and reliable and may be a valuable source of information for research. This study aimed to measure the quality of PMSI data from three university health centers for core indicators in perinatal health. Method: PMSI data were compared with medical files in 2012 from 300 live births after 22 weeks of amenorrhea, drawn at random from University Hospitals in Dijon, Paris and Nancy. The variables were chosen based on the Europeristat Project's core and recommended indicators, as well as those of the French National Perinatal survey conducted in 2010. The information gathered blindly from the medical files was compared with the PMSI data positive predictive value (PPV) and the sensitivity was used to assess data quality. Results: Data on maternal age, parity and mode of delivery as well as the rates of premature births were superimposable for the two sources. The PPV for epidural injection was 96.2% and 94.3% for perineal tears. Overall, maternal morbidity was underdocumented in the PMSI, so the PPV was 100.0% for pre-existing diabetes, 88.9% for gestational diabetes and 100.0% for high blood pressure with a rate of 9.0% in PMSI and 6.3% in the medical files. The PPV for bleeding during labor was 89.5%. Conclusion: To conclude, PMSI data are apparently becoming more and more reliable for two reasons: on one hand, the importance of these data for budgetary promotion in hospitals; on the other, the increasing use of this information for statistical and epidemiological purposes. © 2015 Elsevier Masson SAS.

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