Blein C, Chamoux C, Reynaud D, Lepage V
HEVA, 186, avenue Thiers, 69465 Lyon, France.
BIOGEN France, 75000 Paris, France.
Rev Epidemiol Sante Publique. 2018 Nov;66(6):385-394. doi: 10.1016/j.respe.2018.08.006. Epub 2018 Oct 8.
The aim of this study is to analyze and to compare data from 2015, focusing on hospital care for patients with multiple sclerosis from three French regions with different characteristics in terms of prevalence, size and number of multiple sclerosis competencies and resource centers.
All hospital admissions from the PMSI MCO 2015 database, with a principal or related diagnosis (PD-RD) of G35* ("multiple sclerosis") were extracted. We also extracted chemotherapy treatments administered in hospital, during admissions with a significant associated diagnosis (SAD) of G35*, if the PD or RD was coded Z512 ("non-tumor chemotherapy"). The analyzed regions corresponded to those of 2015, some of which have since merged.
There were 95,359 hospital admissions for multiple sclerosis in France in 2015 among a total cohort of 21,102 patients, resulting in a total cost of € 54.1m. Patients with MS were managed mainly in the ambulatory setting, which accounted for 88.5 % of all admissions. The Rhône-Alpes region represented 7.6 % of national admissions for MS, 9.6 % of patients, and 14 % of inpatient days, contributing 10.4 % of the national cost of MS care. 58.4 % of stays were managed by the two main multiple sclerosis centers. The Nord-Pas-de-Calais region represented 9.8 % of national admissions, 10 % of patients, 6.6 % of inpatient days, and 9.1 % of the national cost. 29.8 % of stays were managed by the main multiple sclerosis center. The Centre region represented 2.7 % of stays, 2.8 % of patients, 3.1 % of inpatient days, and 2.8 % of the national cost. 28.4 % of stays were managed by the main multiple sclerosis center.
This study highlights the diversity of multiple sclerosis hospital management and care between these three regions.
本研究旨在分析和比较2015年的数据，重点关注法国三个在多发性硬化症患病率、规模以及多发性硬化症诊疗能力和资源中心数量方面具有不同特征地区的患者住院治疗情况。
从2015年PMSI MCO数据库中提取所有主要诊断或相关诊断（PD-RD）为G35*（“多发性硬化症”）的住院病例。如果主要诊断或相关诊断为G35*且主要诊断或相关诊断编码为Z512（“非肿瘤化疗”），我们还提取住院期间进行的化疗治疗。分析的地区与2015年的地区相对应，其中一些地区后来进行了合并。
2015年法国共有21,102名患者因多发性硬化症住院95,359次，总费用为5410万欧元。多发性硬化症患者主要在门诊环境中接受治疗，占所有住院病例的88.5%。罗讷-阿尔卑斯大区的多发性硬化症住院病例占全国的7.6%，患者占9.6%，住院天数占14%，占全国多发性硬化症治疗费用的10.4%。58.4%的住院病例由两个主要的多发性硬化症中心管理。北部加来海峡大区的住院病例占全国的9.8%，患者占10%，住院天数占6.6%，占全国费用的9.1%。29.8%的住院病例由主要的多发性硬化症中心管理。中央大区的住院病例占2.7%，患者占2.8%，住院天数占3.1%，占全国费用的2.8%。28.4%的住院病例由主要的多发性硬化症中心管理。
本研究突出了这三个地区在多发性硬化症住院管理和护理方面的多样性。
