Care pathway diversity of patients with multiple sclerosis between French regions

Abstract

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 2015database, 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 95,359hospital admissions for multiple sclerosis in France in 2015among a total cohort of 21,102patients, 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.