• Family practice · Apr 2024

    The French ecology of medical care. A nationwide population-based cross sectional study.

    • Catherine Laporte, Frédéric Fortin, Julie Dupouy, David Darmon, Bruno Pereira, Nicolas Authier, Jessica Delorme, Chouki Chenaf, Hubert Maisonneuve, and Matthieu Schuers.
    • Département de Médecine Générale, Université Clermont Auvergne, UFR de Médecine et Profession paramédicales de Clermont-Ferrand, F-63000 Clermont-Ferrand, France.
    • Fam Pract. 2024 Apr 15; 41 (2): 929892-98.

    PurposeStudies in the United States, Canada, Belgium, and Switzerland showed that the majority of health problems are managed within primary health care; however, the ecology of French medical care has not yet been described.MethodsNationwide, population-based, cross sectional study. In 2018, we included data from 576,125 beneficiaries from the General Sample of Beneficiaries database. We analysed the reimbursement of consultations with (i) a general practitioner (GP), (ii) an outpatient doctor other than a GP, (iii) a doctor from a university or non-university hospital; and the reimbursement of (iv) hospitalization in a private establishment, (v) general hospital, and (vi) university hospital. For each criterion, we calculated the average monthly number of reimbursements reported on 1,000 beneficiaries. For categorical variables, we used the χ2 test, and to compare means we used the z test. All tests were 2-tailed with a P-value < 5% considered significant.ResultsEach month, on average, 454 (out of 1,000) beneficiaries received at least 1 reimbursement, 235 consulted a GP, 74 consulted other outpatient doctors in ambulatory care and 24 in a hospital, 13 were hospitalized in a public non-university hospital and 10 in the private sector, and 5 were admitted to a university hospital. Independently of age, people consulted GPs twice as much as other specialists. The 13-25-year-old group consulted the least. Women consulted more than men. Individuals covered by complementary universal health insurance had more care.ConclusionsOur study on reimbursement data confirmed that, like in other countries, in France the majority of health problems are managed within primary health care.© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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