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  1. Article ; Online: Burden and patient characteristics associated with repeat consultation for unscheduled care within 30 days in primary care: a retrospective case control study with implications for aging and public health.

    Richard, Valentin / Bouazzi, Leila / Richard, Clément / Sanchez, Stéphane

    Frontiers in public health

    2023  Volume 11, Page(s) 1079755

    Abstract: Introduction: Repeated consultations in primary care represent a significant burden on healthcare services. Characterizing the patients who repeatedly attend ambulatory care would enhance our understanding of the healthcare needs of this population, ... ...

    Abstract Introduction: Repeated consultations in primary care represent a significant burden on healthcare services. Characterizing the patients who repeatedly attend ambulatory care would enhance our understanding of the healthcare needs of this population, with a view to providing appropriate services. The aim of this study was therefore to identify the factors associated with repeated consultation in unscheduled care. Our secondary aim was to explore the specific profile of patients aged >65 years.
    Methods: A retrospective case-control study comparing re-consultation within 30 days at a primary care facility versus non-reconsulting patients, defined as those who did not reconsult within 30 days, among patients consulting over a period of 1 year (1 January to 31 December 2019). Data was collected for a random sample of 5,059 consultations. Patients and controls were matched for age ± 5 years, and sex.
    Results: The main factors associated with repeat consultation were an initial consultation late at night (midnight to 6.00 am; OR 1.31, 95%CI 1.20-1.44), and psychological disorders as the main diagnosis (OR 1.33, 95%CI 1.20-1.48). Conversely, consulting at the weekend was associated with a lower likelihood of repeat consultation (OR 0.82, 95% 0.85-0.91).
    Conclusion: 30-day reconsultations were significantly more frequent after late night consultation. This could be used as an indicator of the quality of care to assess performance of general practice teams with implications for improving overall health of an aging population.
    MeSH term(s) Humans ; Aged ; Case-Control Studies ; Retrospective Studies ; Public Health ; Referral and Consultation ; Aging ; Primary Health Care
    Language English
    Publishing date 2023-07-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.1079755
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  2. Article ; Online: Prospective, observational study of the impact of finger food on the quality of nutrition evaluated by the simple evaluation of food intake (SEFI) in nursing home residents.

    Carrette, Justine / Chrusciel, Jan / Ecarnot, Fiona / Sanchez, Stéphane

    Aging clinical and experimental research

    2023  Volume 35, Issue 8, Page(s) 1661–1669

    Abstract: Introduction: Finger food is a type of meal that can be eaten without cutlery, and may, therefore, be easier to consume for patients with cognitive disorders. The objective of this study was to assess whether finger food increased the quantity of food ... ...

    Abstract Introduction: Finger food is a type of meal that can be eaten without cutlery, and may, therefore, be easier to consume for patients with cognitive disorders. The objective of this study was to assess whether finger food increased the quantity of food ingested among older nursing home residents. The secondary objectives were to evaluate satisfaction after meals and costs associated with the meals.
    Methods: This was a single-center prospective study conducted on paired observations, comparing food intake observed during three finger food meals vs. three "control" meals (standard meals), for the same residents, in a public nursing home, from 21 April to 18 June 2021.
    Results: A total of 266 meals were evaluated for 50 residents. The mean intake (simple evaluation of food intake) score was 40.7 ± 1.7 out of 50 with finger food, and 39.0 ± 1.5 for standard meals. Finger food was associated with a higher probability of an intake score ≥ 40 (odds ratio [OR] 1.91 (95% CI 1.15-3.18; p = 0.01). The difference in satisfaction scores following the meals did not reach statistical significance: 3.86 (SD 1.19) vs. 3.69 (SD 1.11) for the finger food and standard meals, respectively; p = 0.2. Finger foods had an excess cost of 49% compared to a standard meal.
    Conclusion: The occasional or seasonal (rather than systematic) use of these meals seems to be a valid option to reintroduce novelty and pleasure into the residents' diet. However, potential adopters should be aware that the finger food meals were 49% more expensive than standard meals.
    MeSH term(s) Humans ; Prospective Studies ; Energy Intake ; Nutritional Status ; Nursing Homes ; Eating
    Language English
    Publishing date 2023-06-07
    Publishing country Germany
    Document type Observational Study ; Journal Article
    ZDB-ID 2104785-6
    ISSN 1720-8319 ; 1594-0667
    ISSN (online) 1720-8319
    ISSN 1594-0667
    DOI 10.1007/s40520-023-02444-5
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  3. Article ; Online: Hysteroscopy after conservative surgical treatment of severe postpartum hemorrhage due to uterine atony: A systematic literature review.

    Zouaghi, Chiheb / Chaouch, Mohamed Ali / Sanchez, Stephane / Zouaghi, Sondes

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Volume 162, Issue 2, Page(s) 462–471

    Abstract: Objective: To assess the prevalence of intrauterine anomalies, primarily intrauterine adhesions (IUAd), after conservative surgical treatment of severe postpartum hemorrhage with uterine atony (SPPH-UA) and determine patient eligibility for hysteroscopy. ...

    Abstract Objective: To assess the prevalence of intrauterine anomalies, primarily intrauterine adhesions (IUAd), after conservative surgical treatment of severe postpartum hemorrhage with uterine atony (SPPH-UA) and determine patient eligibility for hysteroscopy.
    Methods: PubMed and the Cochrane Library were searched by combining keywords "postpartum hemorrhage", "uterine atony", and "hysteroscopy" to perform a literature review. Articles in French and English with more than five cases of hysteroscopy following SPPH-UA were selected. All cases that had hysteroscopy after conservative surgical treatment of SPPH-UA were collected. A blinded statistical analysis revealed IUAd risk factors.
    Results: In all, 83% of patients agreed to hysteroscopy and 38% of 71 cases had an IUAd. Age was not a risk factor (P = 0.950). Other factors included multiparity (odds ratio [OR] 1.93, P = 0.039), cesarean delivery (OR 3.58, P = 0.584) and postpartum infection (OR 3.33, P = 0.04). Risk was at 57% after uterine padding with multiple transfixing square stitches (Cho-technique) (P = 0.001), 6% after non-transfixing uterine folding brace suture (B-Lynch technique) when used alone, 29% after uterine artery embolization and after internal iliac artery ligation (OR 0.98, P = 0.645); uterine vascular ligation (OR 0.69, P = 0.253) and more than two procedures (OR 0.69, P = 2.53). Disparity between authors was observed (P = 0.015) and concerned only the surgical techniques used.
    Conclusion: A classification is proposed for deciding post-SPPH hysteroscopy. Further studies are required to determine appropriateness.
    MeSH term(s) Pregnancy ; Female ; Humans ; Suture Techniques/adverse effects ; Postpartum Hemorrhage/therapy ; Uterus/surgery ; Uterus/blood supply ; Uterine Inertia/surgery ; Uterine Diseases/surgery ; Postpartum Period
    Language English
    Publishing date 2023-03-01
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.14704
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    Zs.MO 183: Show issues

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  4. Article ; Online: Effectiveness of Prevention Interventions Using Social Marketing Methods on Behavioural Change in the General Population: A Systematic Review of the Literature.

    Roger, Aude / Dourgoudian, Mikael / Mergey, Virginie / Laplanche, David / Ecarnot, Fiona / Sanchez, Stéphane

    International journal of environmental research and public health

    2023  Volume 20, Issue 5

    Abstract: In an effort to encourage people to adopt healthy behaviours, social marketing is increasingly used in disease prevention and health promotion. This systematic review aimed to evaluate the effect of prevention initiatives that use social marketing ... ...

    Abstract In an effort to encourage people to adopt healthy behaviours, social marketing is increasingly used in disease prevention and health promotion. This systematic review aimed to evaluate the effect of prevention initiatives that use social marketing techniques on achieving behavioural change in the general population. We conducted a systematic review of PubMed, Embase, Science Direct, Cochrane, and Business Source Complete. Among 1189 articles identified across all databases, 10 studies met the inclusion criteria (six randomized controlled trials and four systematic reviews). The number of social marketing criteria used varies according to the studies. The results showed positive effects overall, albeit not always statistically significant. The quality of the studies was mixed: 3/4 of the systematic reviews did not meet the methodological criteria, and four out of six randomized trials had at least a high risk of bias. Social marketing is not fully exploited in prevention interventions. However, the greater the number of social marketing criteria used, the more positive the effects observed. Social marketing thus appears to be an interesting concept to bring about behavioural change, but it requires rigorous monitoring to ensure maximum effectiveness.
    MeSH term(s) Humans ; Social Marketing ; Health Promotion/methods ; Bias
    Language English
    Publishing date 2023-03-04
    Publishing country Switzerland
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20054576
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  5. Article ; Online: Évaluation de la mise en application des recommandations 2021 de la Société Européenne de Cardiologie pour l'insuffisance cardiaque à fraction d'éjection réduite chez les patients âgés de plus de 75 ans.

    Dacunka, Marianne / Sanchez, Stéphane / Raoul, Florian / Chapoutot, Laurent / Maillier, Bruno / Marchais, Aurélie

    Annales de cardiologie et d'angeiologie

    2023  Volume 72, Issue 4, Page(s) 101646

    Abstract: Introduction: Heart failure is a frequent pathology with a poor prognosis which mainly concerns elderly patients. The recommandations concerning the pharmagical treatment in heart failure with LVEF are reduced on randomized trials carried out on a young ...

    Title translation Evaluation of the implementation of the 2021 guidelines of the European Society of Cardiology for heart failure with reduced ejection fraction in patients aged over 75.
    Abstract Introduction: Heart failure is a frequent pathology with a poor prognosis which mainly concerns elderly patients. The recommandations concerning the pharmagical treatment in heart failure with LVEF are reduced on randomized trials carried out on a young population. The aim of this work is to evaluate their application on a population aged ≥ 75.
    Materials and methods: This is a retrospective, bicentric cohort, concerning patients hospitalized between September 1, 2021 and March 31, 2023, at the hospital centers of Troyes and Romilly sur Seine. The primary endpoint was a composite endpoint combining rehospitalisation rate or all-cause death rate at 6 months.
    Results: A group of 81 patients was included in the study. The average number of treatments is associated with a significant reduction in the rate of hospitalisations ord deaths at 6 months (p = 0,005); as it concerns the level of titration, the analysing comparing the "therapeutic inertia" group and the "current titration/maximum tolerated dose" group did not reveal any significant difference (p = 0,169).
    Conclusion: Our study highlighted the potential positive impact of the application of the latest ESC recommendations concerning first-line drug treatment on the rate of rehospitalisation or death from all causes, in patients with heart failure reduced LVEF aged over 75.
    Language French
    Publishing date 2023-09-08
    Publishing country France
    Document type English Abstract ; Journal Article
    ZDB-ID 418425-7
    ISSN 1768-3181 ; 0003-3928
    ISSN (online) 1768-3181
    ISSN 0003-3928
    DOI 10.1016/j.ancard.2023.101646
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  6. Article ; Online: Perceptions, representations and logics of action of urinary incontinence in institutionalised elderly people: a concurrent mixed study protocol.

    Peroni, Lea / Armaingaud, Didier / Sanchez, Stéphane / Rothan-Tondeur, Monique

    BMJ open

    2022  Volume 12, Issue 3, Page(s) e057639

    Abstract: Introduction: Urinary incontinence (UI) is a major public health problem. It affects many institutionalised elderly people. In the literature, the phenomenon is well defined. Its frequency, risk factors, individual and social costs, as well as the ... ...

    Abstract Introduction: Urinary incontinence (UI) is a major public health problem. It affects many institutionalised elderly people. In the literature, the phenomenon is well defined. Its frequency, risk factors, individual and social costs, as well as the different therapeutic approaches, are described. However, there are few publications on its representations, both from the point of view of the patient and that of the carers. However, the literature shows that a better understanding of the social representations of this phenomenon could be a vector for improving care. We aim at understanding the perception of UI, to model its representations and to understand and characterise the logics of action in terms of protection.
    Methods and analysis: This will be a mixed-method concurrent study with a quantitative and a qualitative component. Data will be collected through 100 semistructured interviews, 8 focus groups and 10 000 surveys from 4 populations: institutionalised elderly people, caregivers, carers and individuals from the general population. The qualitative part will be analysed both manually and with ATLAS.Ti software, which will be used to centralise and organise all qualitative data collected. For the analysis of the quantitative part, a descriptive statistical analysis and a logistic regression type association will be carried out. These analyses will be enforced using R software. Then, an overlay and combination of quantitative and qualitative information for the triangulation analytical approach will be carried out. The study started in August 2021 and will continue until June 2022.
    Ethics and dissemination: The study protocol was approved by the Descartes ethics and research committee on 1 June 2021, with the IRB number 00012021-43. The findings will be published in peer-reviewed journals and presented at national and international conferences.
    Trial registration number: This protocol was registered with the Research Registry on 12 July 2021 and is numbered researchregistry6965.
    MeSH term(s) Aged ; Cohort Studies ; Humans ; Logic ; Research Design ; Surveys and Questionnaires ; Urinary Incontinence/epidemiology ; Urinary Incontinence/therapy
    Language English
    Publishing date 2022-03-31
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-057639
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  7. Article ; Online: Republication de : Évaluation de la mise en application des recommandations 2021 de la Société Européenne de Cardiologie pour l'insuffisance cardiaque à fraction d'éjection réduite chez les patients âgés de plus de 75 ans.

    Dacunka, Marianne / Sanchez, Stéphane / Raoul, Florian / Chapoutot, Laurent / Maillier, Bruno / Marchais, Aurélie

    Annales de cardiologie et d'angeiologie

    2023  Volume 72, Issue 5, Page(s) 101680

    Abstract: Introduction: Heart failure is a frequent pathology with a poor prognosis which mainly concerns elderly patients. The recommandations concerning the pharmagical treatment in heart failure with LVEF are reduced on randomized trials carried out on a young ...

    Title translation Republication of: Evaluation of the implementation of the 2021 guidelines of the European Society of Cardiology for heart failure with reduced ejection fraction in patients aged over 75.
    Abstract Introduction: Heart failure is a frequent pathology with a poor prognosis which mainly concerns elderly patients. The recommandations concerning the pharmagical treatment in heart failure with LVEF are reduced on randomized trials carried out on a young population. The aim of this work is to evaluate their application on a population aged ≥ 75.
    Materials and methods: This is a retrospective, bicentric cohort, concerning patients hospitalized between September 1, 2021 and March 31, 2023, at the hospital centers of Troyes and Romilly sur Seine. The primary endpoint was a composite endpoint combining rehospitalisation rate or all-cause death rate at 6 months.
    Results: A group of 81 patients was included in the study. The average number of treatments is associated with a significant reduction in the rate of hospitalisations ord deaths at 6 months (p = 0,005); as it concerns the level of titration, the analysing comparing the "therapeutic inertia" group and the "current titration/maximum tolerated dose" group did not reveal any significant difference (p = 0,169).
    Conclusion: Our study highlighted the potential positive impact of the application of the latest ESC recommendations concerning first-line drug treatment on the rate of rehospitalisation or death from all causes, in patients with heart failure reduced LVEF aged over 75.
    MeSH term(s) Aged ; Humans ; Stroke Volume ; Retrospective Studies ; Heart Failure/drug therapy ; Heart Failure/epidemiology ; Hospitalization ; Cardiology ; Ventricular Function, Left
    Language French
    Publishing date 2023-10-14
    Publishing country France
    Document type English Abstract ; Journal Article
    ZDB-ID 418425-7
    ISSN 1768-3181 ; 0003-3928
    ISSN (online) 1768-3181
    ISSN 0003-3928
    DOI 10.1016/j.ancard.2023.101680
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  8. Article ; Online: Does the implementation of pay-for-performance indicators improve the quality of healthcare? First results in France.

    Sanchez, Marc-Antoine / Sanchez, Stéphane / Bouazzi, Leila / Peillard, Louise / Ohl-Hurtaud, Aline / Quantin, Catherine

    Frontiers in public health

    2023  Volume 11, Page(s) 1063806

    Abstract: Background: Pay-for-performance (P4P) models are intended to promote quality of care in both hospitals and primary care settings. They are considered as a means of changing medical practices, particularly in primary care.: Objectives: The first ... ...

    Abstract Background: Pay-for-performance (P4P) models are intended to promote quality of care in both hospitals and primary care settings. They are considered as a means of changing medical practices, particularly in primary care.
    Objectives: The first objective of this study was to assess how performance indicators changed over time, measured through "Remuneration on Public Health Objectives" (ROSP) scores, between 2017 and 2020 in a large French region (Grand Est region), and to compare this evolution in the rural vs. urban areas of the region. The second objective was to focus on the area with the least improvement in ROSP scores and to investigate whether the scores and the available sociodemographic characteristics of the area were associated.
    Methods: First, we measured the evolution over time of P4P indicators (i.e., ROSP scores) obtained from the regional health insurance system, for GP practices in the Grand Est region between 2017 and 2020. We then compared the scores between the Aube Department and the rest of the region (urban areas). To address the second objective, we focused on the area found to have the least improvement in indicators to investigate whether there was a relationship between ROSP score and sociodemographic characteristics.
    Results: More than 40,000 scores were collected. We observed an overall improvement in scores over the study period. The urban area (Grand Est region minus the Aube) scored better than the rural area (Aube) for chronic disease management [median 0.91 (0.84-0.95) vs. 0.90(0.79-0.94),
    Conclusions: At the regional level, the overall improvement in scores observed between 2017 and 2020 suggests that the implementation of ROSP indicators have improved the quality of care, particularly in urban areas. These results also suggest that efforts should be focused on rural areas, which already had the lowest scores at the start of the P4P program.
    MeSH term(s) Reimbursement, Incentive ; Delivery of Health Care ; France ; Hospitals ; Quality of Health Care
    Language English
    Publishing date 2023-03-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.1063806
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  9. Article ; Online: The impact of hospital support function centralization on patient outcomes: A before-after study.

    Le Guillou, Adrien / Chrusciel, Jan / Sanchez, Stephane

    Public health in practice (Oxford, England)

    2021  Volume 2, Page(s) 100174

    Abstract: Objectives: This study aimed to evaluate the impact of centralizing hospital support functions such as administration, quality monitoring, procurement, and insurance on patient outcomes in a French regional hospital group.: Study design: A before- ... ...

    Abstract Objectives: This study aimed to evaluate the impact of centralizing hospital support functions such as administration, quality monitoring, procurement, and insurance on patient outcomes in a French regional hospital group.
    Study design: A before-after study was conducted within a medium-sized hospital in a rural region of France including 87,373 hospital stays between 2013 and 2017.
    Methods: The intervention tested was the centralization of support functions: administration, quality monitoring, procurement, and insurance. The outcomes analyzed were patient mortality, 30 day readmissions and average length of stay.
    Results: The odds ratio (OR) for patient mortality after centralization was 0.99 (95%CI, 0.92 to 1.06), and 0.94 (95%CI, 0.90 to 0.96) for readmissions. The multiplicative factor for average length of stay was 0.93 (95%CI 0.92-0.94).
    Conclusions: There was an increase in measured quality of care after the intervention. This study highlights the complexity of assessing the impact of hospital-level centralization on quality-of-care indicators.
    Language English
    Publishing date 2021-08-06
    Publishing country England
    Document type Journal Article
    ISSN 2666-5352
    ISSN (online) 2666-5352
    DOI 10.1016/j.puhip.2021.100174
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  10. Article ; Online: Effect of the Implementation of the French Hospital Regionalization Policy on Patient Mobility.

    Chrusciel, Jan / Clément, Marie-Caroline / Steunou, Sandra / Prost, Thierry / Duclos, Antoine / Sanchez, Stéphane

    Health systems and reform

    2023  Volume 9, Issue 1, Page(s) 2267256

    Abstract: A new law was voted in France in 2016 to increase cooperation between public sector hospitals. Hospitals were encouraged to work under the leadership of local referral centers and to share their support functions (e.g., information systems) with newly ... ...

    Abstract A new law was voted in France in 2016 to increase cooperation between public sector hospitals. Hospitals were encouraged to work under the leadership of local referral centers and to share their support functions (e.g., information systems) with newly created hospital groups, called "Regional Hospital Groups." The law made it compulsory for each public sector hospital to become affiliated with one of 136 newly created hospital groups. The policy's aim was to ensure that all patients were sent to the hospital best qualified to treat their unique condition, among the hospitals available at the regional level. Therefore, we aimed to assess whether this regionalization policy was associated with changes in observed patterns of patient mobility between hospitals. This nationwide observational study followed an interrupted time series design. For each stay occurring from 2014 to 2019, we ascertained whether or not the stay was followed by mobility toward another hospital within 90 days, and whether or not the receiving hospital was part of the same Regional Hospital Group as the sender hospital. The proportion of mobility directed toward the same regional hospital group increased from 22.9% in 2014 (95% CI 22.7-23.1) to 24.6% in 2019 (95% CI 24.4-24.8). However, the absence of discontinuity during the policy change year was consistent with the hypothesis of a preexisting trend toward regionalization. Therefore, the policy did not achieve major changes in patterns of mobility between hospitals. Other objectives of the reform, including long-term consequences on the healthcare offer, remain to be assessed.
    MeSH term(s) Humans ; Mobility Limitation ; Hospitals ; France ; Delivery of Health Care ; Policy
    Language English
    Publishing date 2023-10-27
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 2820935-7
    ISSN 2328-8620 ; 2328-8620
    ISSN (online) 2328-8620
    ISSN 2328-8620
    DOI 10.1080/23288604.2023.2267256
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