Neurological hospitalisations in childhood cancer survivors treated before 2001: findings from the French Childhood Cancer Survivor Study cohort.

Purpose: Childhood cancer survivors (CCS) have an increased risk of developing late chronic diseases, which can be influenced by the cancer type and its treatment. These chronic diseases can be severe and disabling, typically emerging years to decades after treatment. These deficits negatively impact quality of life, intelligence quotient, and memory.

Gender awareness among general practitioners in France: a cross sectional study using the Nijmegen Gender Awareness in Medicine Scale (N-GAMS).

Gender is a key determinant of health and healthcare use. The question of whether physicians are aware of gender issues is important to avoid gender bias in medical practice. This study aimed to validate the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) in a representative population of French general practitioners (GPs) and to analyze their gender sensitivity and the presence of gender stereotypes among them.

Women's preferences for less active ectopic pregnancy treatment: A discrete choice experiment.

Research Question: Shared decision-making has become a hallmark of quality care and is increasingly spotlighted in practice guidelines. Little is known about women's views for treatment of less active ectopic pregnancy. What are the preferences of women for less active ectopic pregnancy treatment-related attributes?

Design: A discrete choice model with 8 attributes depicting ectopic pregnancy treatment including varying levels of first-line treatment effectiveness, length of hospitalization, cost, length of sick leave, of convalescence, need for surgical management, for emergency care during convalescence and for tube removal was used.

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.

The Association Between Age and Admission to an Inappropriate Ward: A Cross-Sectional Survey in France.

Half of elderly patient hospitalizations are preceded by an emergency department (ED) visit. Hospitalization in inappropriate wards (IWs), which is more frequent in case of ED overcrowding and high hospital occupancy, leads to increased morbidity. Elderly individuals are the most exposed to these negative health care outcomes.

Cost-effectiveness analysis of direct admission to acute geriatric unit versus admission after an emergency department visit for elderly patients.

Background: Elderly individuals represent an increasing proportion of emergency department (ED) users. In the Greater Paris University Hospitals (APHP) direct-admission study, direct admission (DA) to an acute geriatric unit (AGU) was associated with a shorter hospital length of stay (LOS), lower post-acute care transfers, and lower risk of an ED return visit in the month following the AGU hospitalization compared with admission after an ED visit. Until now, no economic evaluation of DA has been available.

Trends in clomiphene citrate and gonadotropins use in women with infertility between 2010 and 2017: A population-based study in France.

Purpose: To describe temporal trends and assess factors associated with changes in the prescription of clomiphene citrate and gonadotropins between 2010 and 2017 in women with infertility aged 18-50 from metropolitan France.

Methods: 6321 prevalent women from a representative sample of the national medico-administrative database were identified. We performed a Cochran-Armitage trend test and calculated the rate ratios.

Long-term hospitalisations in survivors of paediatric solid tumours in France.

The late effects of treatments for childhood cancers may lead to severe and multiple health conditions requiring hospitalisation. We aimed to estimate the hospitalisation rate among childhood cancer survivors (CCS) in France, to compare them with the general population and to investigate the associated factors. We matched total of 5439 5-year solid CCS diagnosed before the age of 21 between 1945 and 2000 by sex, birth year and region of residence to 386,073 individuals of the French general population.

The effect of direct admission to acute geriatric units compared to admission after an emergency department visit on length of stay, postacute care transfers and ED return visits.

Background: Compared with conventional hospitalization, admission to an acute geriatric care unit (AGU) is associated with better outcomes in elderly patients. In 2012, 50% of the hospitalizations of elderly patients were preceded by an emergency department (ED) visit. Hospital occupancy, access blocks and overcrowding experienced by patients during ED visits are associated with increased morbidity.

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.

Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM).

Background: Childhood cancer survivors (CCS) may require lifelong medical care due to late effects of cancer treatments. Little is known about of their healthcare utilization and expenditures at long-term especially in publicly funded health care system. We aim to estimate and describe the health care expenditures among long-term CCS in France.

The economic burden of infertility treatment and distribution of expenditures overtime in France: a self-controlled pre-post study.

Background: Recent cost studies related to infertility treatment have focused on assisted reproductive technologies. None has examined lower-intensity infertility treatments or analyzed the distribution of infertility treatment expenditures over time. The Purpose of the study was to analyse the size and distribution of infertility treatment expenditures over time, and estimate the economic burden of infertility treatment per 10,000 women aged 18 - 50 in France from a societal perspective.

Risk-seeking attitude in health and safety domain is associated with continuous positive airway pressure discontinuation in patients with obstructive sleep apnea-a multicenter prospective cohort study.

Study Objectives: Many studies have already looked at factors that may influence adherence to continuous positive airway pressure (CPAP) (severity of obstructive sleep apnea (OSA), patients' age, technical aspects, socioeconomic factors, living conditions, psychological factors). Although it has been shown that individuals' preference for risky behaviors in daily life can influence the use of care or adherence to drug therapies in care settings, this has never been tested in OSA. This study aims to analyze the association between risk attitude in the health/safety domain and CPAP discontinuation in a cohort of OSA patients.

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.

A top 5 list for French general practice.

Background: Medical overuse is an issue that has recently gained attention. The "Choosing Wisely" campaign invited each specialty in each country to create its own top five lists of care procedures with a negative benefit-risk balance to promote dialogue between patients and physicians. This study aims to create such a list for French general practice.

Determinants of antidementia drug prescription in patients older than 65: A latent class analysis.

Background: Antidementia drugs (cholinesterase inhibitors and memantine) are still widely prescribed despite their controversial effects and 2011 guidelines that no longer encourage their prescription. The objective was to assess which factors remained determinants of antidementia drug prescriptions.

Methods: A cross-sectional study was performed in 2013.

Measuring public preferences in France for potential consequences stemming from re-allocation of healthcare resources.

When deciding which new programme to implement and where the additional resources, if needed, will come from, the decision makers need to accommodate the uncertainty of the potential changes in population health and medical expenditures that can occur. They also need to determine the value of these potential changes. The objective of this study is to identify a public valuation function measuring how the public values changes in population health and medical expenditures when healthcare resources are re-allocated.

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Introduction: Over the past decade, the balance between the benefits and harms of breast cancer screening (BCS) has been widely debated. To date, no French study has interrogated women's points of view and preferences (in the economic sense) for this controversial screening. This study aims to bridge this gap.

[Eliciting women’s preferences for breast cancer screening].

Introduction: Over the past decade, the balance between the benefits and harms of breast cancer screening (BCS) has been widely debated. To date, no French study has interrogated women's points of view and preferences (in the economic sense) for this controversial screening. This study aims to bridge this gap.

Cost-effectiveness analysis of medical management versus conservative surgery for early tubal pregnancy.

Study Question: Is conservative surgery (laparoscopic salpingotomy) cost-effective, using fertility as the endpoint compared with medical management (Methotrexate) in women with an early tubal pregnancy?

Summary Answer: Conservative surgery appeared slightly, but not statistically significantly, more effective than medical management but also more costly.

What Is Known Already: Women with an early tubal pregnancy treated with medical therapy (Methotrexate) or conservative surgery (laparoscopic salpingotomy) have comparable future intrauterine pregnancy rates by natural conception. Also, cost-minimisation studies have shown that medical therapy was less expensive than conservative surgery, but there is no cost-effectiveness study comparing these two treatments with fertility as the endpoint.

Measuring Public Preferences for Health Outcomes and Expenditures in a Context of Healthcare Resource Re-Allocation.

Background: The final outcome of any resource allocation decision in healthcare cannot be determined in advance. Thus, decision makers, in deciding which new program to implement (or not), need to accommodate the uncertainty of different potential outcomes (i.e.

Continuous positive airway pressure therapy for obstructive sleep apnoea and psychotropic drug use: a retrospective observational matched-cohort study.

Patients with obstructive sleep apnoea (OSA) frequently present symptoms of depression, anxiety and insomnia and continuous positive airway pressure (CPAP) can improve these symptoms. Using a real-world administrative database, we analysed the trend of psychotropic drug use (antidepressants, anxiolytics and hypnotics) on a long-term period in OSA individuals before-after CPAP initiation. A total of 869 OSA individuals to whom psychotropic drugs were prescribed were followed for 4 years.