@article{Morvan_Bernadou_Gautier_Silue_Jeannel_2017, title={Spatial analysis of SS population coverage based on emergency regional healthcare}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7767}, DOI={10.5210/ojphi.v9i1.7767}, abstractNote={<div style="left: 79.8182px; top: 284.47px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08117);" data-canvas-width="56.563006734006734">Objective</div><div style="left: 93.1234px; top: 297.724px; font-size: 12.564px; font-family: serif; transform: scaleX(0.991881);" data-canvas-width="337.3552407407406">To analyse population coverage of syndromic surveillance(SS)</div><div style="left: 79.8182px; top: 312.499px; font-size: 12.564px; font-family: serif; transform: scaleX(0.978598);" data-canvas-width="350.58259158249143">based on emergency care data by studying i)the attractiveness of</div><div style="left: 79.8182px; top: 327.275px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02861);" data-canvas-width="349.9342905723905">respectively SOS Médecins (Emergency care general practitioners)</div><div style="left: 79.8182px; top: 342.05px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997105);" data-canvas-width="350.8979473063971">and Hospital emergency departments in the Centre-Val de Loire</div><div style="left: 79.8182px; top: 356.825px; font-size: 12.564px; font-family: serif; transform: scaleX(1.05303);" data-canvas-width="350.1491345117843">region and ii) the contribution of ecological deprivation factors in</div><div style="left: 79.8182px; top: 371.6px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01585);" data-canvas-width="163.28139393939395">emergency access to healthcare.</div><div style="left: 79.8182px; top: 399.732px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1234px; top: 412.986px; font-size: 12.564px; font-family: serif; transform: scaleX(0.974182);" data-canvas-width="335.2645956228955">SOS Médecins France (SOS Med) is the first private and permanent</div><div style="left: 79.8182px; top: 427.761px; font-size: 12.564px; font-family: serif; transform: scaleX(0.993274);" data-canvas-width="348.70553400673396">network of general practitioners providing emergency care in France.</div><div style="left: 79.8182px; top: 442.536px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03688);" data-canvas-width="352.2963175084174">Besides Hospital emergency departments (HED), SOS Med is</div><div style="left: 79.8182px; top: 457.312px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0411);" data-canvas-width="345.9590494949489">therefore a major source of data for detecting and measuring near-</div><div style="left: 79.8182px; top: 472.087px; font-size: 12.564px; font-family: serif; transform: scaleX(0.98925);" data-canvas-width="348.69422643097636">real-time health phenomena. The emergency services provided by the</div><div style="left: 79.8182px; top: 486.862px; font-size: 12.564px; font-family: serif; transform: scaleX(0.993495);" data-canvas-width="348.81609696969696">SOS Med have been subject to important changes in the recent years.</div><div style="left: 79.8182px; top: 501.637px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00165);" data-canvas-width="349.05983804713793">Their services are enriched by a medical consultation center together</div><div style="left: 79.8182px; top: 516.413px; font-size: 12.564px; font-family: serif; transform: scaleX(0.972619);" data-canvas-width="350.7911535353533">with extended working hours. Besides, the south of the region is</div><div style="left: 79.8182px; top: 531.188px; font-size: 12.564px; font-family: serif; transform: scaleX(0.972496);" data-canvas-width="350.3740296296298">markedly affected by a declining number of medical practitioners</div><div style="left: 79.8182px; top: 545.963px; font-size: 12.564px; font-family: serif; transform: scaleX(0.980516);" data-canvas-width="348.57361228956205">This study was conducted to analyze the regional population coverage</div><div style="left: 79.8182px; top: 560.738px; font-size: 12.564px; font-family: serif; transform: scaleX(0.962354);" data-canvas-width="350.20064680134664">of emergency healthcare data provided by HED and SOS Med to</div><div style="left: 79.8182px; top: 575.514px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03549);" data-canvas-width="352.2221900673398">the French syndromic surveillance system (SurSaUD®) taking</div><div style="left: 79.8182px; top: 590.289px; font-size: 12.564px; font-family: serif; transform: scaleX(0.986425);" data-canvas-width="350.7233080808083">into account distance, health care offer, demographic factors and</div><div style="left: 79.8182px; top: 605.064px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00138);" data-canvas-width="152.4763771043771">ecological deprivation factors.</div><div style="left: 79.8182px; top: 633.196px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1234px; top: 646.45px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00597);" data-canvas-width="335.87520471380475">An analysis of the activities and geographic attraction was carried</div><div style="left: 79.8182px; top: 661.225px; font-size: 12.564px; font-family: serif; transform: scaleX(0.986049);" data-canvas-width="348.5849198653199">out based on the data respectively provided by the three regional SOS</div><div style="left: 79.8182px; top: 676px; font-size: 12.564px; font-family: serif; transform: scaleX(0.964748);" data-canvas-width="350.1390833333331">Med and three HED (Bourges, Orléans and Tours). Quasi-Poisson</div><div style="left: 79.8182px; top: 690.775px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00772);" data-canvas-width="349.1766829966331">regression modelling was used to identify the factors influencing the</div><div style="left: 79.8182px; top: 705.551px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03458);" data-canvas-width="349.8438299663299">attractiveness of each organization. Next, the findings were refined</div><div style="left: 79.8182px; top: 720.326px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02469);" data-canvas-width="349.7596513468013">through spatial analysis of the attractiveness of HED and SOS Med</div><div style="left: 79.8182px; top: 735.101px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0129);" data-canvas-width="346.1939957912456">and analysis of the contribution of deprivation based on socio-</div><div style="left: 79.8182px; top: 749.876px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00134);" data-canvas-width="279.824808080808">economical and healthcare facilities ecological indexes.</div><div style="left: 79.8182px; top: 778.008px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 93.1234px; top: 791.262px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02143);" data-canvas-width="336.3048925925925">In terms of age group, children under 2 years required the largest</div><div style="left: 79.8182px; top: 806.037px; font-size: 12.564px; font-family: serif; transform: scaleX(0.960482);" data-canvas-width="350.4318239057239">service consultations as well as seniors over 75 who sought more</div><div style="left: 79.8182px; top: 820.813px; font-size: 12.564px; font-family: serif; transform: scaleX(0.976267);" data-canvas-width="348.6251245791246">emergency visits at home. The SOS Med were almost always active in</div><div style="left: 79.8182px; top: 835.588px; font-size: 12.564px; font-family: serif; transform: scaleX(0.990511);" data-canvas-width="348.80855858585846">urban areas and at least once in two due to continuity of care. So they</div><div style="left: 79.8182px; top: 850.363px; font-size: 12.564px; font-family: serif; transform: scaleX(0.950649);" data-canvas-width="350.0448535353534">are an efficient source of general medical care given present work</div><div style="left: 79.8182px; top: 865.138px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03448);" data-canvas-width="349.9129318181817">hours. Distance as an influential factor may explain the differences</div><div style="left: 79.8182px; top: 879.913px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01575);" data-canvas-width="349.4681671717171">in attraction to the support type. The extent of the attraction appears</div><div style="left: 79.8182px; top: 894.689px; font-size: 12.564px; font-family: serif; transform: scaleX(0.969256);" data-canvas-width="350.54741245791246">in 36% SOS Med Bourges and 14% for SOS Med Orleans. Add</div><div style="left: 79.8182px; top: 909.464px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04059);" data-canvas-width="349.7433181818181">the extent of attraction for SOS, remote consultation for SOS Med</div><div style="left: 79.8182px; top: 924.239px; font-size: 12.564px; font-family: serif; transform: scaleX(0.985167);" data-canvas-width="348.5685867003366">associations are a good use of care in general practice in present work</div><div style="left: 79.8182px; top: 939.014px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00063);" data-canvas-width="71.87848989898988">hours scheme.</div><div style="left: 93.1234px; top: 953.79px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02074);" data-canvas-width="338.6644067340067">In terms of monitoring of epidemics, we note that the SOS</div><div style="left: 79.8182px; top: 968.565px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02136);" data-canvas-width="349.7470873737373">Médecins associations are most active in winter, particularly during</div><div style="left: 79.8182px; top: 983.34px; font-size: 12.564px; font-family: serif; transform: scaleX(0.987034);" data-canvas-width="348.55476632996624">the seasonal epidemics of influenza. This can be explained by the fact</div><div style="left: 79.8182px; top: 998.115px; font-size: 12.564px; font-family: serif; transform: scaleX(0.992782);" data-canvas-width="348.7809178451176">of patient referrals during calls. The most serious cases are redirected</div><div style="left: 79.8182px; top: 1012.89px; font-size: 12.564px; font-family: serif; transform: scaleX(0.988344);" data-canvas-width="351.2572769360268">to the ED and cases of general medicine to the SOS Médecins.</div><div style="left: 79.8182px; top: 1027.67px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01272);" data-canvas-width="276.87729999999993">It is also important to note that the attraction of ED of</div><div style="left: 356.665px; top: 1027.67px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01559);" data-canvas-width="69.02646801346802">CHR Orléans</div><div style="left: 79.8182px; top: 1042.44px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04525);" data-canvas-width="349.8438299663302">covers more or less important a large part of the regional territory,</div><div style="left: 79.8182px; top: 1057.22px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0063);" data-canvas-width="167.09581616161614">which is not visible to the ED of</div><div style="left: 246.894px; top: 1057.22px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00633);" data-canvas-width="62.5937138047138">CH Bourges</div><div style="left: 309.488px; top: 1057.22px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00524);" data-canvas-width="119.48966582491582">. It should nevertheless</div><div style="left: 452.302px; top: 282.685px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01239);" data-canvas-width="100.31076094276094">be noted that the</div><div style="left: 552.638px; top: 282.685px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0335);" data-canvas-width="73.49924242424241">CHR Orleans</div><div style="left: 626.163px; top: 282.685px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01322);" data-canvas-width="177.85308989898996">a larger bed capacity than the</div><div style="left: 452.302px; top: 297.46px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00431);" data-canvas-width="62.46807407407407">CH Bourges</div><div style="left: 514.77px; top: 297.46px; font-size: 12.564px; font-family: serif;">.</div><div style="left: 452.302px; top: 325.592px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 465.608px; top: 338.846px; font-size: 12.564px; font-family: serif; transform: scaleX(0.946434);" data-canvas-width="336.67804259259236">This research has analysed the changes taking place in the SOS</div><div style="left: 452.302px; top: 353.621px; font-size: 12.564px; font-family: serif; transform: scaleX(0.966785);" data-canvas-width="350.1855700336697">médecins associations in the Centre-Val de Loire region. Findings</div><div style="left: 452.302px; top: 368.396px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02644);" data-canvas-width="349.8802654882155">shows that these associations help ensure access to general medical</div><div style="left: 452.302px; top: 383.172px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02208);" data-canvas-width="349.75588215488204">care in a context of strongly reduced medical demography although</div><div style="left: 452.302px; top: 397.947px; font-size: 12.564px; font-family: serif; transform: scaleX(1.035);" data-canvas-width="352.05508922558926">with an uneven, primarily urban, geographical coverage. With</div><div style="left: 452.302px; top: 412.722px; font-size: 12.564px; font-family: serif; transform: scaleX(0.950052);" data-canvas-width="349.9041370370369">better knowledge of the geographic span and sources and types of</div><div style="left: 452.302px; top: 427.497px; font-size: 12.564px; font-family: serif; transform: scaleX(0.991814);" data-canvas-width="350.7383848484847">emergency care provision, further research can be undertaken to</div><div style="left: 452.302px; top: 442.273px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00481);" data-canvas-width="179.3255875420876">further refine and interpret the data.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Morvan, Esra and Bernadou, Anne and Gautier, Ludivine and Silue, Yassungo and Jeannel, Dominique}, year={2017}, month={May} }