Vigneron Emmanuel
Bull Acad Natl Med. 2016 Mar;200(3):497-512; discussion 512-3.
There are major geographic disparities in the practice of coronary angioplasty and coronarography in France. Their study shows that the frequency of these procedures is linked to the density of private medical practice (cardiologist's offices or clinics). This is not observed as far as coronary artery bypass surgery is concerned. This indicates an induction effect from simply on demand. However, this cannot give indication on the pertinence of those acts since this induction effect may as well be beneficial to patients. Nevertheless, this study gives an insight to the regulatory authorities (Regional Health Agencies and the National "Direction Générale de l'Offre de Soins") which have to manage health care system performance on the basis of the principles set out and international guidelines so as to provide equal access for all to a quality healthcare system.
在法国，冠状动脉血管成形术和冠状动脉造影术的实施存在显著的地域差异。他们的研究表明，这些手术的频率与私人医疗业务（心脏病专家办公室或诊所）的密度有关。就冠状动脉旁路移植术而言，并未观察到这种情况。这表明存在单纯按需的诱导效应。然而，这无法说明这些行为的相关性，因为这种诱导效应可能对患者也有益。尽管如此，这项研究为监管当局（地区卫生机构和国家“医疗服务总司”）提供了见解，这些监管当局必须根据既定原则和国际准则来管理医疗保健系统的绩效，以便让所有人都能平等地享有优质的医疗保健系统。
