Chapireau F
Institut national d'études démographiques, MSE, 133, boulevard Davout, 75980 Paris cedex 20, France.
Rev Epidemiol Sante Publique. 2008 Dec;56(6):399-406. doi: 10.1016/j.respe.2008.09.005. Epub 2008 Nov 14.
French public statistics to be used in psychiatry are currently being reorganized. The Academy of Sciences and professionals have stated that epidemiologists should be involved when large databases are being designed.
The three parts of the current French public statistics system are described: routine data, comprehensive census surveys and surveys with representative samples. Epidemiologic goals for public statistics are analysed according to two lines: the study of inequalities of access to care as well as during care and the study of populations in care. Some consequences on the way indicators are used are discussed.
The importance of the question of access to care in psychiatry is known since the epidemiologic catchment area research. Although inequalities of access to psychiatric care are an important research field, few studies are related to them in France. They should be studied in France all the more since public psychiatry is sectorised since 1960 in order to provide continuity of care. Models can be used to that end, most notably the two books about the pathway to care by Golberg and Huxley, as well as the mental health matrix by Thornicroft and Tansella. The internal dynamics of populations in psychiatric care are closely related to the preceding questions; several examples of possible researches are given. However, since populations in care are constructed, their construction process must be analysed, lest comparisons between populations be biased. Three factors help describe this process: the relations with neighbouring populations, the propensity to enter the population in care and the perimeter of the population in care. Consequences on the use of indicators are discussed in relation to three examples: prevalence, length of care and rehospitalisation rates.
It is important to organize a consistent information system about psychiatric care, based upon a thorough problem analysis. The issues at stake and the results to be expected go beyond the sole psychiatric domain.
目前法国用于精神病学的公共统计数据正在进行重组。科学院和专业人士表示，在设计大型数据库时应让流行病学家参与。
描述了当前法国公共统计系统的三个部分：常规数据、全面普查和代表性样本调查。根据两条主线分析了公共统计的流行病学目标：对获得护理的不平等情况以及护理期间的不平等情况进行研究，以及对接受护理的人群进行研究。讨论了对指标使用方式的一些影响。
自流行病学服务区域研究以来，人们就知道精神病学中获得护理问题的重要性。尽管获得精神科护理的不平等是一个重要的研究领域，但法国很少有相关研究。鉴于自1960年以来公共精神病学已进行部门划分以提供连续护理，因此在法国更应开展此类研究。为此可以使用一些模型，最值得注意的是戈德堡和赫胥黎关于护理途径的两本书，以及索恩克罗夫特和坦塞拉的心理健康矩阵。接受精神科护理人群的内部动态与上述问题密切相关；给出了一些可能的研究示例。然而，由于接受护理的人群是构建出来的，必须分析其构建过程，以免人群之间的比较出现偏差。有三个因素有助于描述这一过程：与相邻人群的关系、进入接受护理人群的倾向以及接受护理人群的范围。结合三个示例讨论了对指标使用的影响：患病率、护理时长和再住院率。
基于全面的问题分析，组织一个关于精神科护理的一致信息系统非常重要。所涉及的问题和预期结果超出了单纯的精神病学领域。
