Estimation de l'exhaustivité des données de facturation des médecins pour la détermination des cas de diabète au moyen des données sur les médicaments d'ordonnance (original) (raw)
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Revue d'Épidémiologie et de Santé Publique, 2009
Background.-Data derived from Health Insurance databases are very useful for health observation. These data are however still underused, particularly for small local areas. This may be partly explained by the lack of reliable data on the number of insured people. Recent simplification of the Répertoire national interrégimes de l'assurance-maladie (RNIAM) indicator (French register of health insurance) gives the opportunity to improve the usefulness of these databases. This indicator specifies the beneficiaries' status towards the General Health Insurance Fund. This study aimed to select the population of beneficiaries, which could be most adequately used to calculate health indicators based on these data. Methods.-Data were collected from the outpatient database of the Southeastern France General Health Fund. We compared beneficiaries' characteristics according to the RNIAM indicator, calculated the annual unadjusted and age-adjusted regional and local prevalence of diabetes mellitus in two different populations: the whole initial beneficiaries database, and the population of ''effective'' beneficiaries (persons whose reimbursements were effectively managed by the General Health Insurance). Results.-The initial database included 4,817,871 beneficiaries. Almost 80% were in the ''effective'' population, 14% had left the General Health Insurance, or Southeastern France, and 4% were doubles. The annual unadjusted prevalence of diabetes mellitus was 3.31% in the initial database, and more than 20% higher when calculated among ''effective'' beneficiaries. Impact on aged-adjusted prevalence was less important (+9% at regional level), but the increase varied from 6 to 42% for the small local areas. Impact was much higher on age and gender specific rates. Conclusion.-When Health Insurance databases are used to calculate health indicators at various geographical levels, only ''effective'' beneficiaries should be selected. The methodology for determining health indicators might be improved by updating databases (e.g. the date of the RNIAM indicator last update should be added).
La Revue du praticien, 2011
notamment la prescription médicamenteuse, pour laquelle les « explications sur les risques fréquents ou graves normalement prévisibles » sont explicitement citées (art. R.4127 du CSP). À cette obligation d’information répond celle de la recherche du « consentement libre et éclairé de la personne sans lequel aucun traitement ne peut être pratiqué » (art. R.4127-36 du CSP). Contexte Tout médecin est tenu, par le code de déontologie médicale 1 et la partie réglementaire du Code de la santé publique (CSP),2 d’apporter au patient « une information médicale claire, loyale et appropriée sur son état, les investigations et les soins qu’il lui propose » (art. R.4127-35 du CSP). Cette obligation concerne Summary Feasibility, in general practice, to give to the patients clear, loyal and appropriate information about the undesirable side effects of the medicines prescribed. EICLAT study
Feasibility, in general practice, to give to the patients clear, loyal and appropriate information about the undesirable side effects of the medicines prescribed. EICLAT study Drug prescription in general practice is present in 78 to 83% of consultations; practitioners must give to their patient clear loyal and appropriate information about the undesirable side effects of the medicines prescribed. The object of the EICLAT study was to give some light on the feasibility to respect this obligation. To that effect the study evaluates, for a normal prescription activity, the average number of potential undesirable side effects (USE) in relation with the number of lines of different medicines prescribed in each doctor's prescription. A total of 8,382 doctor's prescriptions, generating 34,427 lines of prescriptions given by 175 general practitioners, were analysed. Amongst these prescriptions, 11% included only one line, 55% from 2 to 4 lines and 34% 5 lines or more. The average doctor's prescription was of 4 lines of medicines generating 407 potential USE, of which 194 were different (the same undesirable effect may be present twice or more in the same doctor's prescription), and 293 frequent or serious potential USE, of which 166 were different. The patent medicines with a major or important added medical value (AMV), present in 7,840 doctor's prescriptions for a total of 24,127 lines exposed the patient, in the average, to 151 frequent or serious USE different. The patent medicines with an insufficient AMV, present in 2,292 prescriptions for a total of 3,887 lines, exposed the patient to 37 frequent and/or serious potential USE. Supposing that the information provided by the legal authority is sufficiently adequate, precise and exhaustive, the volume of information that must be given to the patient is not compatible with the present conditions of exercise of the profession.
Intégration des données de prescription dans un entrepôt de données biomédicales
2014
Integration of drugs-related data into a clinical data warehouse and its good use is a key issue, prescriptions being at the center of patient care in a hospital. Using an independent drugdatabase, Thériaque, and a standardized definition of prescriptions and medications the CIO (InterOperable Classification), we were able to implement a brand new facet to Roogle, our search engine. We enabled the user to search for a drug prescription either by selecting corresponding ATC codes, or directly with a search form including autocompletion and duplicates management. Althought a lot of work is still to be done, these developments pave the way to whole new ways to create cohorts of patients for clinical studies, or to find potential adverse effects related to a specific drug. Mots-clés : Informatique médicale ; Conférence ; Entrepôt de données ; Médicaments ; Prescription : Big data
2018
Resume Objectif : Comprendre le cadre normatif et les modalites de codage des sejours hospitaliers par les archivistes du Centre hospitalier universitaire Sainte-Justine. Mise en contexte : Au Quebec, chaque hospitalisation de patient au sein du reseau de la sante est codee par un archiviste medical, selon les exigences du ministere de la Sante et des Services sociaux. Le codage de chaque hospitalisation est utilise a des fins statistiques, de surveillance, d’evaluation de l’acte ou encore de recherche. Avec la mise en place future du financement axe sur les patients au Quebec, le codage sera egalement utile pour etablir la base budgetaire de chaque etablissement de sante. Resultats : En procedant a une revue de la litterature scientifique, nous avons etabli une carte heuristique des termes pertinents pour le codage des sejours hospitaliers. Nous avons aussi propose des definitions de chaque terme, cartographie le processus, rencontre l’equipe des archivistes et etabli un profil de ...