Are breast cancer patients with suboptimal adherence to cardiovascular treatment more likely to discontinue adjuvant endocrine therapy? Competing risk survival analysis in a nationwide cohort of postmenopausal women.

Background: High rates of discontinuation undermine the effectiveness of adjuvant endocrine therapy (AET) among hormone-receptive breast cancer patients. Patient prognosis also relies on the successful management of cardiovascular risk, which affects a high proportion of postmenopausal women. As with AET, adherence with cardiovascular drugs is suboptimal.

Effect of comorbidities on healthcare expenditures for patients on kidney replacement therapy considering the treatment modality and duration in a French cohort.

End-stage kidney disease (ESKD) is associated with a substantial economic burden. In France, the cost of care for such patients represents 2.5% of the total French healthcare expenditures but serves less than 1% of the population.

Recurrent high grade glioma surgery with carmustine wafers implantation: a long-term nationwide retrospective study.

Purpose: Widespread use of carmustine wafers (CW) to treat high-grade gliomas (HGG) has been limited by uncertainties about its efficacy. To assess the outcome of patients after recurrent HGG surgery with CW implantation and, search for associated factors.

Methods: We processed the French medico-administrative national database between 2008 and 2019 to retrieve ad hoc cases.

Newly Diagnosed High-Grade Glioma Surgery with Carmustine Wafers Implantation. A Long-Term Nationwide Retrospective Study.

Background: Widespread use of carmustine wafers (CWs) to treat high-grade gliomas (HGG) has been limited by uncertainties about their efficacy. We sought to assess the outcome of patients after newly diagnosed HGG surgery with CW implantation and search for associated factors.

Methods: We processed the French medico-administrative national database between 2008 and 2019 to retrieve ad hoc cases.

Underuse of primary healthcare in France during the COVID-19 epidemic in 2020 according to individual characteristics: a national observational study.

Background: The organization of healthcare systems changed significantly during the COVID-19 pandemic. The impact on the use of primary care during various key periods in 2020 has been little studied.

Methods: Using individual data from the national health database, we compared the numbers of people with at least one consultation, deaths, the total number of consultations for the population of mainland France (64.

The Economic Burden of Disease in France From the National Health Insurance Perspective: The Healthcare Expenditures and Conditions Mapping Used to Prepare the French Social Security Funding Act and the Public Health Act.

Background: Identifying the most frequently treated and the costliest health conditions is essential for prioritizing actions to improve the resilience of health systems.

Objectives: Healthcare Expenditures and Conditions Mapping describes the annual economic burden of 58 health conditions to prepare the French Social Security Funding Act and the Public Health Act.

Design: Annual cross-sectional study (2015-2019) based on the French national health database.

Defining a risk-adjustment formula for the introduction of population-based payments for primary care in France.

Novel risk-adjusted payment models for financing primary care are currently being experimented in France. In particular, pilot schemes including shared-savings contracts or prospectively allocated capitation payments are implemented for voluntary primary care structures. Such payment mechanisms require defining a risk-adjustment formula to accurately estimate expected expenditure while maintaining appropriate efficiency incentives.

Cause-Specific Survival After Meningioma Surgery: A Nationwide Population-Based Competing Risk Study.

Background: Survival after meningioma surgery often is reported with inadequate allowance for competing causes of death.

Methods: We processed the French Système National des Données de Santé database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve appropriate cases of meningiomas. The cumulative incidence of meningioma-related death was the primary end point.

Patient stratification for risk of readmission due to heart failure by using nationwide administrative data.

Background: Identifying patients with heart failure (HF) who are most at risk of readmission permits targeting adapted interventions. The use of administrative data enables regulators to support the implementation of such interventions.

Methods And Results: In a French nationwide cohort of patients aged 65 years or older, surviving an index hospitalization for HF in 2015 (N = 70,657), we studied HF readmission predictors available in administrative data, distinguishing HF severity from overall morbidity and taking into account the competing mortality risk, over a 1-year follow-up period.

Late-onset pseudoepitheliomatous hyperplasia developing within a red ink tattoo.

The popularity of tattoos has increased dramatically worldwide particularly in the last three decades, giving rise to the frequent occurrence of a wide spectrum of secondary cutaneous and systemic complications. Pseudoepitheliomatous hyperplasia (PEH) is a benign irregular hyperplasia of the epidermis occurring in response to various stimuli, that clinically and histopathologically resembles cutaneous neoplasms such as squamous cell carcinoma and keratoacanthoma. In an attempt to improve the awareness of the possible occurrence of PEH in tattoos and of its diagnostic and therapeutic aspects, we present herein the case of a 30-year-old woman with histologically confirmed PEH related to a red-ink tattoo.

Health policy analysis of the non-implementation of HPV vaccination coverage in the pay for performance scheme in France.

Background: The French National Cancer Control Plan (NCCP) launched in 2014 set the objective to improve human papillomavirus (HPV) vaccination coverage (VC). The NCCP included a measure to integrate a VC indicator in the pay for performance (P4P) scheme for general practitioners (GPs), which was not implemented. The objective of the study was to analyse the reasons for non-implementation of this measure, using the health policy analysis framework.

Two morbidity indices developed in a nationwide population permitted performant outcome-specific severity adjustment.

Objective: The objective of the study was to develop and validate two outcome-specific morbidity indices in a population-based setting: the Mortality-Related Morbidity Index (MRMI) predictive of all-cause mortality and the Expenditure-Related Morbidity Index (ERMI) predictive of health care expenditure.

Study Design And Setting: A cohort including all beneficiaries of the main French health insurance scheme aged 65 years or older on December 31, 2013 (N = 7,672,111), was randomly split into a development population for index elaboration and a validation population for predictive performance assessment. Age, gender, and selected lists of conditions identified through standard algorithms available in the French health insurance database (SNDS) were used as predictors for 2-year mortality and 2-year health care expenditure in separate models.

Effect of pay-for-performance on cervical cancer screening participation in France.

Pay-for-performance (P4P) has been increasingly used across different healthcare settings to incentivize the provision of targeted services. In this study, we investigated the effect of a nationwide P4P scheme for general practitioners implemented in 2012 in France, on cervical cancer screening practices. Using data from a nationally representative permanent sample of health insurance beneficiaries, we analyzed smear test use of eligible women for the years 2006-2014.

Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey.

Background: Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France.