... Page 2. - 2 - (see for example Scott, 20011). We should simply note that, in France, control ... more ... Page 2. - 2 - (see for example Scott, 20011). We should simply note that, in France, control is assured by means of more or less coercive actions introduced when young doctors —set up“ practice. ... Scott and Shiell (1997) obtain similar results for Australia. ...
BackgroundThis paper is aimed at investigating the extents to which illness modifies labour suppl... more BackgroundThis paper is aimed at investigating the extents to which illness modifies labour supply and employment conditions of people with chronic diseases (defined as severe diseases giving rise to 100% coverage of health expenditures by the Sickness Fund).
Poor people receive shorter consultations in general practice than more affluent people. Our aim ... more Poor people receive shorter consultations in general practice than more affluent people. Our aim was to study the two reasons generally advanced for this for patients consulting with mental health problems: people of low socioeconomic status (SES) demand shorter consultations or they tend to match with practitioners who devote little time to their patients. Of 600 general practitioners (GPs), 144 agreed to participate. During the study period (2005), 713 patients consulted with mental health problems of whom 405 (56.8%) completed questionnaires. Of these, 144 (34.8%) were defined as suffering from Major Depressive Disorder (MDD). Multilevel modelling was used to explore the relationship between patient and GP characteristics, and duration of the consultation. A multivariate model found two significant patient variables for the consultation duration: severity of MDD symptoms (P = 0.01) and SES (proxied by education level, P = 0.05). The multilevel model including GPs' characteristics demonstrated that the apparent correlation between patients' SES and consultation length was due to a confounding factor: low SES patients were visiting GPs who are, generally, providing shorter consultations (P < 0.001). With the SES variable no longer significant: P = 0.2, although severity of symptoms remained in the model (P = 0.001). The shortness of the consultation length is due to a supply-side effect, implicating dissatisfaction for patients with mental health problems. This may not be generalizable to other patients. Findings are in favour of a specific intervention aimed at giving poor people equal access to GPs' time.
Today, a growing need exists for greater research into cancer survivorship, focusing on different... more Today, a growing need exists for greater research into cancer survivorship, focusing on different spheres of the day-to-day life of diagnosed patients. This article describes the design and implementation of VICAN (VIe après le CANcer), a national survey on French cancer survivors. The target population included patients aged 18-82, diagnosed with cancer between January and June 2010, and registered in one of the three main French Health Insurance Schemes. It was restricted to 12 tumour sites. Sampling was stratified using a non-proportional allocation, based on age at diagnosis (18-52 and 53-82) and tumour site. Data were collected from telephone interviews with patients 2 and 5 years after diagnosis, a medical survey completed by the physician who initiated cancer treatment, and information from the national medicoadministrative database on reimbursement data and hospital discharge records. First data collection, 2 years after diagnosis, occurred between March and December 2012. S...
Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique, 2004
This article presents a study on General Practitioners' (GPs) knowledge, attitudes and practi... more This article presents a study on General Practitioners' (GPs) knowledge, attitudes and practice towards disabled patients. A sample of 600 private general practitioners practising in Southeastern France was selected in 2002 with a random sampling approach stratified according to age, sex, and size of the urban unit. A standardised questionnaire was used to collect data by telephone. Results are presented as percentages. Comparisons used Pearson's chi2 test. Ninety percent of the GPs reported that they had to provide social assistance to their disabled patients (protecting their rights, administrative assistance, family counselor, etc.) as well as coordinating care by various other professionals. GPs frequently reported the presence of barriers that compromised the health care of disabled patients: lack of information (62.8%), time (50.2%), co-ordination between health professionals (37.7%), and training (37.7%), as well as communication problems (20.7%) and the need for assi...
Presse médicale (Paris, France : 1983), Jan 21, 2003
To evaluate the willingness, reasons and perceived obstacles to prescription by international non... more To evaluate the willingness, reasons and perceived obstacles to prescription by international non-proprietary name (INN) among general practitioners (GPs) in private practice. Method A panel of private GPs practicing in South-eastern France was surveyed twice, 2 months before and 5 months after a new contract between the National Health Insurance system and GP associations (5 June 2002). The panel was constructed with a random sampling approach stratified according to age, sex, and size of the urban unit. Between March-April and November-December 2002, the percentage of GPs willing to prescribe according to INN rose from 76.2% to 89.7%. These physicians reported that their principal reasons for such prescription were the June agreement and concern about the finances of the Health Insurance system. The principal obstacles they mentioned were the complexity of prescription by INN (66%), lack of appropriate information and tools (47%), and patient reticence (41%). More effort must be d...
General practitioners&amp... more General practitioners' (GPs') use of clinical practice guidelines (CPGs) may be influenced by various contextual and attitudinal factors. This study examines general attitudes toward CPGs to establish profiles according to these attitudes and to determine if these profiles are associated with awareness and with use of CPGs in daily practice. The authors conducted a cross-sectional telephone survey of 1,759 French GPs and measured (a) their general attitudes toward CPGs and (b) their awareness and use in daily practice of CPGs for six specific health problems. A bivariate probit model was used with sample selection to analyze the links between GPs' general attitudes and CPG awareness/use. The authors found three GP profiles according to their opinions toward CPGs and a positive association between these profiles and CPG awareness but not use. It is important to build awareness of CPGs before GPs develop negative attitudes toward them.
This paper is devoted to the analysis of the General Practitioners' (GPs) labour supply, spec... more This paper is devoted to the analysis of the General Practitioners' (GPs) labour supply, specifically focusing on the physicians' labour supply responses to higher compensations. This analysis is mainly aimed at challenging the reality of a ‘backward bending' form for the labour supply of GPs. Because GPs' fees only evolve very slowly and are mainly fixed by the National Health
... Page 2. - 2 - (see for example Scott, 20011). We should simply note that, in France, control ... more ... Page 2. - 2 - (see for example Scott, 20011). We should simply note that, in France, control is assured by means of more or less coercive actions introduced when young doctors —set up“ practice. ... Scott and Shiell (1997) obtain similar results for Australia. ...
BackgroundThis paper is aimed at investigating the extents to which illness modifies labour suppl... more BackgroundThis paper is aimed at investigating the extents to which illness modifies labour supply and employment conditions of people with chronic diseases (defined as severe diseases giving rise to 100% coverage of health expenditures by the Sickness Fund).
Poor people receive shorter consultations in general practice than more affluent people. Our aim ... more Poor people receive shorter consultations in general practice than more affluent people. Our aim was to study the two reasons generally advanced for this for patients consulting with mental health problems: people of low socioeconomic status (SES) demand shorter consultations or they tend to match with practitioners who devote little time to their patients. Of 600 general practitioners (GPs), 144 agreed to participate. During the study period (2005), 713 patients consulted with mental health problems of whom 405 (56.8%) completed questionnaires. Of these, 144 (34.8%) were defined as suffering from Major Depressive Disorder (MDD). Multilevel modelling was used to explore the relationship between patient and GP characteristics, and duration of the consultation. A multivariate model found two significant patient variables for the consultation duration: severity of MDD symptoms (P = 0.01) and SES (proxied by education level, P = 0.05). The multilevel model including GPs' characteristics demonstrated that the apparent correlation between patients' SES and consultation length was due to a confounding factor: low SES patients were visiting GPs who are, generally, providing shorter consultations (P < 0.001). With the SES variable no longer significant: P = 0.2, although severity of symptoms remained in the model (P = 0.001). The shortness of the consultation length is due to a supply-side effect, implicating dissatisfaction for patients with mental health problems. This may not be generalizable to other patients. Findings are in favour of a specific intervention aimed at giving poor people equal access to GPs' time.
Today, a growing need exists for greater research into cancer survivorship, focusing on different... more Today, a growing need exists for greater research into cancer survivorship, focusing on different spheres of the day-to-day life of diagnosed patients. This article describes the design and implementation of VICAN (VIe après le CANcer), a national survey on French cancer survivors. The target population included patients aged 18-82, diagnosed with cancer between January and June 2010, and registered in one of the three main French Health Insurance Schemes. It was restricted to 12 tumour sites. Sampling was stratified using a non-proportional allocation, based on age at diagnosis (18-52 and 53-82) and tumour site. Data were collected from telephone interviews with patients 2 and 5 years after diagnosis, a medical survey completed by the physician who initiated cancer treatment, and information from the national medicoadministrative database on reimbursement data and hospital discharge records. First data collection, 2 years after diagnosis, occurred between March and December 2012. S...
Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique, 2004
This article presents a study on General Practitioners' (GPs) knowledge, attitudes and practi... more This article presents a study on General Practitioners' (GPs) knowledge, attitudes and practice towards disabled patients. A sample of 600 private general practitioners practising in Southeastern France was selected in 2002 with a random sampling approach stratified according to age, sex, and size of the urban unit. A standardised questionnaire was used to collect data by telephone. Results are presented as percentages. Comparisons used Pearson's chi2 test. Ninety percent of the GPs reported that they had to provide social assistance to their disabled patients (protecting their rights, administrative assistance, family counselor, etc.) as well as coordinating care by various other professionals. GPs frequently reported the presence of barriers that compromised the health care of disabled patients: lack of information (62.8%), time (50.2%), co-ordination between health professionals (37.7%), and training (37.7%), as well as communication problems (20.7%) and the need for assi...
Presse médicale (Paris, France : 1983), Jan 21, 2003
To evaluate the willingness, reasons and perceived obstacles to prescription by international non... more To evaluate the willingness, reasons and perceived obstacles to prescription by international non-proprietary name (INN) among general practitioners (GPs) in private practice. Method A panel of private GPs practicing in South-eastern France was surveyed twice, 2 months before and 5 months after a new contract between the National Health Insurance system and GP associations (5 June 2002). The panel was constructed with a random sampling approach stratified according to age, sex, and size of the urban unit. Between March-April and November-December 2002, the percentage of GPs willing to prescribe according to INN rose from 76.2% to 89.7%. These physicians reported that their principal reasons for such prescription were the June agreement and concern about the finances of the Health Insurance system. The principal obstacles they mentioned were the complexity of prescription by INN (66%), lack of appropriate information and tools (47%), and patient reticence (41%). More effort must be d...
General practitioners&amp... more General practitioners' (GPs') use of clinical practice guidelines (CPGs) may be influenced by various contextual and attitudinal factors. This study examines general attitudes toward CPGs to establish profiles according to these attitudes and to determine if these profiles are associated with awareness and with use of CPGs in daily practice. The authors conducted a cross-sectional telephone survey of 1,759 French GPs and measured (a) their general attitudes toward CPGs and (b) their awareness and use in daily practice of CPGs for six specific health problems. A bivariate probit model was used with sample selection to analyze the links between GPs' general attitudes and CPG awareness/use. The authors found three GP profiles according to their opinions toward CPGs and a positive association between these profiles and CPG awareness but not use. It is important to build awareness of CPGs before GPs develop negative attitudes toward them.
This paper is devoted to the analysis of the General Practitioners' (GPs) labour supply, spec... more This paper is devoted to the analysis of the General Practitioners' (GPs) labour supply, specifically focusing on the physicians' labour supply responses to higher compensations. This analysis is mainly aimed at challenging the reality of a ‘backward bending' form for the labour supply of GPs. Because GPs' fees only evolve very slowly and are mainly fixed by the National Health
Uploads
Papers by A. Paraponaris