PubMed | Center dAide a rret du Tabagisme, 4681 University dAuvergne, Service de Biostatistique et dInformatique Medicale DIM and University of Burgundy
Type: | Journal: Tobacco induced diseases | Year: 2016
Hard core smokers have been studied in many countries but only a few trials have compared the effectiveness of smoking cessation with other smokers. The objective of this study was to compare the frequencies of success in smoking cessation between hard-core smokers and other smokers.Data were collected in Clermont-Ferrand from the Emile Roux dispensary Pneumology and Tobaccology Centre between 1999 and 2009. Assistance with smoking cessation was proposed to 1367 patients but only 1296 patients were included: 219 HCS and 1077 other smokers. Smoking cessation was considered a success when patients were abstinent 6months after the beginning of cessation. The profiles of the two types of smokers were compared using Chi square test and Students t test. Multivariate logistic regression was used to investigate the association between the smoking cessation result and the type of smokers.HCS more frequently consumed other psychoactive substances (41.1% vs 25.7% for other smokers; Smoking cessation is possible for hard core smokers, who should be treated as other types of smokers taking into account other factors:the problem is how to encourage them to try to stop smoking.
Evaluation of the metrological quality of the medico-administrative data for perinatal indicators: A pilot study in 3 university hospitals [Évaluation de la qualité métrologique des données du programme de médicalisation du système dinformation (PMSI) en périnatalité: Étude pilote réalisthomampers]
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.
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.
PubMed | Service de Biostatistique et dInformatique Medicale DIM and University of Burgundy
Type: | Journal: International journal of health geographics | Year: 2016
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.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 ascending hierarchical classification) using INSEE socio-economic data and mortality rates was also carried out to identify different area profiles.Between 2008 and 2011, the number of stroke patients increased by 3.85%, notably for ischemic stroke in the 36-55 years age group (60% of men). Over the same period, in-hospital mortality fell, and the map of standardized rates illustrated the diagonal of high mortality extending from the north-east to the south-west of the country. The most severely affected areas were also those with the least favorable socio-professional indicators.The PMSI-MCO database is a major source of data on the health status of the population. It can be used for the area-by-area observation of the performance of certain healthcare indicators, such as in-hospital mortality, or to follow the implementation of the National Stroke Plan. Our study showed the interplay between social and demographic factors and stroke-related in-hospital mortality. The map derived from the results of the exploratory analysis illustrated a variety of areas where social difficulties, aging and high mortality seemed to meet. The study raises questions about access to neuro-vascular care in isolated areas and in those in demographic decline. Telemedicine appears to be the solution favored by decision makers. The aging of the population managed for stroke must not mask the growing incidence in younger people, which raises questions about the development of classical (smoking, hypertension) or new (drug abuse) risk factors.
PubMed | Center Detudes Perinatales Of Locean Indien, Service de Biostatistique et dInformatique Medicale DIM and University of Burgundy
Type: Journal Article | Journal: BMC pediatrics | Year: 2017
Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31weeks of gestational age (GA).This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32-43weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 - 28), post-neonatal hospitalization (day of life 29 - 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used.The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p<0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 - 40 and increased at 43weeks and this persisted after adjustment (aRR=3.6 [95% CI: 3.3-3.9] at 32 and 1.5 [95% CI: 1.1-1.9] at 43 compared to 40weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85, with a significant decrease (p<0.001) according to GA at birth (aRR=3.8 [95% CI: 2.4-5.8] at 32 and 6.6 [95% CI: 2.1-20.9] at 43, compared to 40weeks.Theres a continuous change in outcome in hospitalized infants born above 31weeks. Birth at 40weeks gestation is associated with the lowest 1-year morbidity and mortality.