Tuppin P, Blotière P O
Caisse Nationale D'assurance Maladie des Travailleurs Salariés, Paris Cedex, France.
Bull Soc Pathol Exot. 2012 May;105(2):79-85. doi: 10.1007/s13149-012-0213-5.
Complementary Universal Health Insurance (CMUC) which provides free access to health care has been available in France since 2000 for people with an annual income less than 60% of the poverty threshold. Hospitalization rates in 2009 for common diseases among immigrants were compared between beneficiaries of the general scheme under the age of 60 years with (4.5 millions) or without CMUC (34.1 millions) in 2008 and still alive at the end of the year. Data were derived from the French national health insurance reimbursements and short-stay hospital discharge databases. Age - and sex-adjusted hospitalization rates and relative risk significantly greater overall hospitalization rates (17.5% vs 13.2%) (males RR= 2.0, female RR 2.3) and each parasitic diseases (RR = 2.1), which include viral diseases and fevers of unknown origin (1.1/1000, RR =1.6), septicaemia (0.4/1000, RR = 2.2), HIV infection (0.7/1000, RR = 3.5), other infectious and parasitic diseases (0.7/1000, RR= 2.5) and, more precisely, measles (2.7/1000, RR = 5.0). Hospitalization for sickle cell disease (3%, RR = 4.5) were also more frequent as also for lead poisoning (0.12/1000, RR = 5.2). In this low-income population with free access to health care, hospitalizations were higher for many diseases that are targets for prevention and screening actions. This is tha case for immigrant with CMUC coverage arriving in France and when they travel to their country of origin.
自2000年起,法国就为年收入低于贫困线60%的人群提供了补充全民健康保险(CMUC),该保险可让人们免费获得医疗保健服务。对2008年年龄在60岁以下、参加普通医保计划且年末仍在世的人群进行了比较,其中有450万人享受CMUC,3410万人未享受CMUC,分析了2009年这些人群中移民常见疾病的住院率。数据来源于法国国家健康保险报销数据库和短期住院出院数据库。年龄和性别调整后的住院率及相对风险显示,总体住院率显著更高(17.5%对13.2%)(男性相对风险=2.0,女性相对风险=2.3),每种寄生虫病(相对风险=2.1),包括病毒性疾病和不明原因发热(1.1/1000,相对风险=1.6)、败血症(0.4/1000,相对风险=2.2)、艾滋病毒感染(0.7/1000,相对风险=3.5)、其他传染病和寄生虫病(0.7/1000,相对风险=2.5),更确切地说,麻疹(2.7/1000,相对风险=5.0)。镰状细胞病的住院率(3%,相对风险=4.5)也更高,铅中毒的住院率(0.12/1000,相对风险=5.2)同样如此。在这个可免费获得医疗保健服务的低收入人群中,许多作为预防和筛查行动目标的疾病的住院率更高。对于抵达法国且有CMUC覆盖的移民以及他们返回原籍国时的情况都是如此。