Pathologies cardiovasculaires et recours à l’hospitalisation par le médecin généraliste : facteurs influençant le choix du secteur d’hospitalisation

Abstract

ObjectivesWhen a hospitalisation is required in France, the general practitioner has the choice between public or private hospitals. The reasons for this choice are poorly known. MethodsAll the cases of hospitalisation requirement reported between 1997 and 2001 by the general practitioners involved in the Réseau Sentinelles® were included in this study. The cardiovascular reasons were extracted from all these declarations. Factors influencing the general practitioners’ choice between public and private sector were assessed by using logistic regression. ResultsDuring the study period, 45,960 cases of hospitalisation requirement were reported. Amongst these cases, 4475 (10.8%) were made for clearly defined cardivoascular diseases (cardiac failure 38.0%, coronary heart disease 24.7%, atrial fibrillation 11.7%, pulmonary embolism 8.4%, hypertension 3.6%, pericarditis 1.6%, cardiovascular check-up 1.5%). Referrals to private sector depended on the reason for hospitalisation, cardiovascular check-up being the reasons the most referred to a private institution (33.8% of patients) and cardiac insufficiency the less referred to private institution (17.2% of patients). Referral to private sector was also associated with physician (patient's usual general practitioner) and consultation (consultation outside of a context of emergency) characteristics. ConclusionWhether patients suffering from cardiovascular diseases are sent to a public or private sector is not completely haphazard. Further analyses are needed in the context of new French health policies.