for A dults in France Isabelle DurandZaleski 2016 International Health Policy Survey Webinar May 18 2017 Entire population covered for healthcare Rate of coverage varies by type of care ID: 755159
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Slide1
Access to
Health Care for Adults in France
Isabelle Durand-ZaleskiSlide2
2016 International Health Policy Survey Webinar | May 18,
2017Entire population covered for healthcare
Rate of
coverage
varies by type of care (e.g., from 80% for hospital admissions to 15% for lifestyle drugs)95% of the population has complementary insurance, which can be state-sponsored Public/private mix of service provision, extra billing is permitted
Overview
Isabelle
Durand-ZaleskiSlide3
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
15%
adults
report a serious chronic condition and are therefore eligible for full health care coverage for that conditionAn additional 5% report a health problemCurrent Health SituationSlide4
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
In
theory
affordability should not be an issue, but some problems remain:Chronic conditions coverage: for a prespecified package and NOT for situations that are unrelated to the conditionExtra billing Glasses and hearing aidsDental care
A
ffordabilitySlide5
State-
sponsored
Quality of Coverage by Income Level
Isabelle
Durand-Zaleski2016 International Health Policy Survey Webinar | May 18,
2017Slide6
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
Out-of-Pocket
P
ayment, by Age, for Low-Income PatientsSlide7
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
Insufficient
supply of doctors in small towns and rural areas:Current experiments:Financial incentivesMedical homesDoctors from other EU countriesTask shifting: nurses, pharmacistsEmailsThe issue of payment
is not solved
Access to CareSlide8
2016 International Health Policy Survey Webinar | May 18,
2017Geographic or for specific populations: telemedicine experiments
in
every
regioneg the Paris regionElderly persons in nursing homesNeonatesPrisonersAccess to SpecialistsIsabelle Durand-ZaleskiSlide9
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
Strictly
defined and controlled Validation of content by the National Health Authority and specific reimbusement scheduleEnsures that programmes are evidence-based BUT may send to GPs the message that patients’ education is to be
left to specialists
Patient
E
ducation
P
rogrammesSlide10
2016 International Health Policy Survey Webinar | May 18,
2017A major issue, and has been for many yearsfew
incentives
Governance
gap:medical \socialHospital \ office-based physiciansCare CoordinationIsabelle Durand-ZaleskiSlide11
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
health centers (
centres
de santé; CDS) that bring together salaried professionals multidisciplinary health homes (maisons de santé pluriprofessionnelle; MSP) where the professionals are self employed 800 MSPs and 600 CDSs that account for just over 10% of GPsDeveloping internal coordination among teams of primary care providers Slide12
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
By region, at the request of healthcare professionals
information and referral of professionals
to the available health, social and medical-social resources in the territory using a dedicated telephone number;support for the organization of complex pathways for a duration that is adapted to the needs of the patient, within a framework inspired by “case management.”The implementation of territorial support platformsSlide13
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
S
upport
for professional practices and initiatives partner
partner
partner
Operator:
region
Components:
local
netwoks
,
local
iniatives
Partners: remote
resouces
eg
nursing
homes
,
social
services
Slide14
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
Implemented in 2014 in nine pilot regions in France
Includes persons aged over 75 years, high risk of loss of autonomy:
patients at home: fragile, prescription of certain classes of drugs, or presence of one or more chronic condition;hospitalized: admitted to the hospital via the emergency department.Institutionalized: residential care homes for disabled frail elderly Programmes for elderly patientsSlide15
2016 International Health Policy Survey Webinar | May 18,
2017Isabelle Durand-Zaleski
Current coordination experiments
respond to:
the diversity of professional practice the needs of the users of the French health system.organize scaling up at the territorial level based on the subsidiarity principal principlenational coordination by the Minister of health capitalization among the regions.Conclusion