Diffusion de la réhabilitation améliorée après chirurgie en France. Étude nationale à grande échelle, à partir des données du PMSI.

IF 0.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Sante Publique Pub Date : 2024-01-01
Laurent Delaunay, Karem Slim, Emmanuel Briquet, Jean Joris, Thierry Boudemaghe, Lucas Leger, Frédéric Bizard
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引用次数: 0

Abstract

Introduction: The aim of this study was to analyze the rate of enhanced recovery programs (ERP) implementation in a range of surgical specialties in both the public and private sectors.

Methods: This was a retrospective longitudinal study based on hospital stays between March to December 2019. We studied thirteen of the activity segments most frequently included in ERP protocol. The procedures selected included digestive, gynecological, orthopedic, thoracic, and urological procedures. The assessment criteria was the rate of ERP. The results were analyzed first overall and then matching ERP stays to non-ERP stays according to type of institution, patient age and sex, month of discharge, and Charlson comorbidity score.

Results: We took 420,031 stays into account, of which 78,119 were coded as ERP. There were 62,403 non-ERP stays. Depending on the type of surgery, the implementation rate ranged from 5 percent to 30 percent. The overall rate of ERP implementation was higher in the private sector (21.2 percent) than in the public sector (14.4 percent). The results are reversed for some surgeries, notably for some cancers. Patients had a higher Charlson score in the public sector.

Conclusions: This large-scale national study provides a picture of the degree of diffusion of ERPs in France. Although there are differences between sectors, this diffusion is still insufficient overall. Given the demonstrated benefits of ERPs, more educational efforts are needed to improve their implementation in France.

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法国术后康复改进措施的推广。利用 PMSI 数据进行的大规模全国性研究。
导言:本研究旨在分析一系列外科专科在公共和私营部门的强化康复计划(ERP)实施率:这是一项基于 2019 年 3 月至 12 月期间住院情况的回顾性纵向研究。我们研究了最常纳入 ERP 方案的 13 个活动环节。所选程序包括消化、妇科、骨科、胸腔和泌尿科程序。评估标准是ERP的使用率。首先对总体结果进行分析,然后根据机构类型、患者年龄和性别、出院月份以及 Charlson 合并症评分,将 ERP 住院治疗与非 ERP 住院治疗进行比对:我们统计了 420,031 次住院,其中 78,119 次编码为 ERP。非 ERP 住院人数为 62,403 人。根据手术类型的不同,实施率从 5% 到 30% 不等。私立医疗机构的ERP总体实施率(21.2%)高于公立医疗机构(14.4%)。某些手术,尤其是某些癌症手术的结果则相反。公共部门患者的 Charlson 评分更高:这项大规模的全国性研究显示了ERP在法国的普及程度。尽管各部门之间存在差异,但总体而言,普及程度仍然不足。鉴于ERP的优势已得到证实,法国需要更多的教育努力来改善ERP的实施。
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来源期刊
Sante Publique
Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
0.40
自引率
33.30%
发文量
252
审稿时长
>12 weeks
期刊介绍: La revue Santé Publique s’adresse à l’ensemble des acteurs de santé publique qu’ils soient décideurs, professionnels de santé, acteurs de terrain, chercheurs, enseignants ou formateurs, etc. Elle publie des travaux de recherche, des évaluations, des analyses d’action, des réflexions sur des interventions de santé, des opinions, relevant des champs de la santé publique et de l’analyse des services de soins, des sciences sociales et de l’action sociale. Santé publique est une revue à comité de lecture, multidisciplinaire et généraliste, qui publie sur l’ensemble des thèmes de la santé publique parmi lesquels : accès et recours aux soins, déterminants et inégalités sociales de santé, prévention, éducation pour la santé, promotion de la santé, organisation des soins, environnement, formation des professionnels de santé, nutrition, politiques de santé, pratiques professionnelles, qualité des soins, gestion des risques sanitaires, représentation et santé perçue, santé scolaire, santé et travail, systèmes de santé, systèmes d’information, veille sanitaire, déterminants de la consommation de soins, organisation et économie des différents secteurs de production de soins (hôpital, médicament, etc.), évaluation médico-économique d’activités de soins ou de prévention et de programmes de santé, planification des ressources, politiques de régulation et de financement, etc
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