Rev Epidemiol Sante
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Rev Epidemiol Sante · Dec 2002
Comparative Study[Quality of medical database to valorize the DRG model by ISA cost indicators].
The use of the French version of the DRG model is focused on cost allocation, based on the case-mix system and the use a weight called ISA (Synthetic Index of Activity) for each DRG. However, this administrative database is becoming more and more used by both researchers and health policy makers for health planning and benchmarking. In France, data abstraction and coding of medical records is done by physicians. The objective of this study was to determine the accuracy of a database of the discharge summaries used for DRGs and to compare consequences of inappropriate coding on budget estimation and risk adjustment. ⋯ Discharge summaries used in the French DRGs system consistently underestimate the presence of comorbid conditions, which has direct implications for policy-makers comparing performance between hospital units. Both clinical practitioners and policy makers should be aware of this bias when assessing patient's quality of care or performing health planning through discharge summaries.
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Rev Epidemiol Sante · Dec 2002
Comparative Study[Prior use of a telephone-nursing triage service by patients of emergency services].
A province-wide telephone-nursing triage service was implemented in Quebec, Canada, in order, among other objectives, to decrease overcrowding in hospital emergency rooms. This study analyses prior use of Info-Sante CLSC telephone service by patients of emergency services. ⋯ Despite a heightened awareness of the telephone-nursing triage service, few users of emergency services make use of it and, when they do, follow rather loosely the recommendation towards the type of service judged appropriate for their needs.
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Rev Epidemiol Sante · Dec 2002
Comparative Study[Macro-economic calculation of spending versus micro-economic follow-up of costs of breast cancer].
In the healthcare field, the ability to make economic forecasts requires knowledge of the costs of caring for major diseases. In the case of a semi-chronic condition like cancer, this cost covers all the episodes of care associated with a patient. An evaluation of a macro-economic method of calculating costs for treating non-metastatic cancer, covering all hospital episodes, is proposed. This method is based entirely on the use of annual hospital activity databases, linked to data concerning the incidence of cancer. It allows us to obtain the global cost of care for a neoplasm of a particular site, without the need to reconstruct the whole care pathway of the patients. ⋯ This method may be extended to all types of neoplasms. This method cannot be used instead of follow-up studies, for cost-efficacy or cost-severity analysis, but may be interesting beyond economic forecasts, in the field of payment per pathology.