The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Florence Baron-papillon - One of the best experts on this subject based on the ideXlab platform.

Jean-jacques Pessey - One of the best experts on this subject based on the ideXlab platform.

  • Prevention of recurrent Rhinopharyngitis in at-risk children in France: a cost-effectiveness model for a nonspecific immunostimulating bacterial extract (OM-85 BV).
    PharmacoEconomics, 2003
    Co-Authors: Jean-jacques Pessey, Françoise Mégas, Benoît Arnould, Florence Baron-papillon
    Abstract:

    Objective: To estimate the pharmacoeconomic impact for the French Social Security System of preventing recurrent acute Rhinopharyngitis (RARP) in at-risk children with OM-85 BV, an immunostimulating agent indicated for the prevention of recurrences.

  • prevention of recurrent Rhinopharyngitis in at risk children in franceness model for a nonspecific immunostimulating bacterial extract om 85 bv
    2003
    Co-Authors: Jean-jacques Pessey, Francoise M Egas, Florence Baronpapillon
    Abstract:

    Security System of preventing recurrent acute Rhinopharyngitis (RARP) in at-risk children with OM-85 BV, an immunostimulating agent indicated for the prevention of recurrences. Design: A decision-analysis model. The probability of progression of the infection and of its associated care, the principal direct costs linked to them, and the effectiveness of OM-85 BV were established or calculated by reviewing the available literature (published between 1984 and 2000). Four experts validated the parameters and the model. Results: For the French Social Security System, the mean direct cost for an acute Rhinopharyngitis (ARP) infection was €49.39 (2000 values). By using OM-85 BV prevention, 1.52 infections were prevented in 6 months saving €67.83 on the costs of care for the recurrently infected child. Sensitivity analyses confirmed the robustness of the model and indicated a saving of between €6.28 and €303.64 in direct costs for each individual treated preventively. Threshold analyses showed that OM-85 BV prophylaxis is economically profitable if more than 0.15 infections are prevented and if direct costs of care of an ARP are greater than €4.78. Conclusion: Non-specific immunotherapy should be considered for the child at risk of RARP and administered in addition to other recommended measures. The economic savings for the community of using a medication for which the clinical effectiveness has been demonstrated should also be taken into account in assessing its usefulness.

  • Prevention of Recurrent Rhinopharyngitis in At-Risk Children in France: A Cost-Effectiveness Model for a Nonspecific Immunostimulating Bacterial Extract (OM-85 BV)
    2026
    Co-Authors: Jean-jacques Pessey, Françoise Mégas, Benoît Arnould, Florence Baron-papillon
    Abstract:

    Objective: To estimate the pharmacoeconomic impact for the French Social Security System of preventing recurrent acute Rhinopharyngitis (RARP) in at-risk children with OM-85 BV, an immunostimulating agent indicated for the prevention of recurrences. Design: A decision-analysis model. The probability of progression of the infection and of its associated care, the principal direct costs linked to them, and the effectiveness of OM-85 BV were established or calculated by reviewing the available literature (published between 1984 and 2000). Four experts validated the parameters and the model. Results: For the French Social Security System, the mean direct cost for an acute Rhinopharyngitis (ARP) infection was Conclusion: Non-specific immunotherapy should be considered for the child at risk of RARP and administered in addition to other recommended measures. The economic savings for the community of using a medication for which the clinical effectiveness has been demonstrated should also be taken into account in assessing its usefulness.Antibronchitic-bacterial-vaccine, Children, Cost-effectiveness, Otorhinolaryngological-infections, Pharmacoeconomics, Vaccines

Mousquès Julien - One of the best experts on this subject based on the ideXlab platform.

  • Primary care and performance : from medical practice variation to the role of the practice organization
    2014
    Co-Authors: Mousquès Julien
    Abstract:

    La recherche économique considère le médecin généraliste comme un agent offrant à l’échange information et services intellectuels en santé à des principaux. L’imparfaite convergence entre leurs objectifs, comme la présence d’incertitudes et d’asymétries d’information, conduisent le médecin à « fixer » les quantités, l’effort fourni et la qualité des soins et services rendus. Cette thèse vise à identifier le rôle des caractéristiques des généralistes, de leur mode d’exercice ou d’organisation, sur la performance de leur activité, en s’appuyant sur trois articles. Le premier analyse les déterminants de la variabilité de prescription d’antibiotiques pour rhinopharyngite aiguë, le second évalue l’impact du travail en équipe avec des infirmières sur la qualité et l’efficience des soins pour les patients diabétiques, et le troisième évalue l’impact de l’exercice regroupé pluriprofessionnel sur l’activité et l’efficience productive des généralistes et l’efficience des recours aux soins ambulatoires de leurs patients. Ces travaux de recherche permettent d’interroger la faiblesse relative de la régulation de l’offre de soins ambulatoire en France en matière de politique de maîtrise de l’évolution des dépenses de santé en comparaison de celle portant sur la demande.According to economic research, the general practitioner is considered as an agent that offered information and intellectual services in health to principals. Imperfect convergence between their objectives, like the presence of uncertainties and information asymmetries, lead the physician “to fix” the quantities, the effort and the quality of the care and services delivered. Based on three articles, this thesis aims at identifying the role of the characteristics of the general practitioners and of their practice organization, on activity performance. The first articles analyzes the determinants of the antibiotic prescription for acute Rhinopharyngitis variability, the second evaluates the impact of team working with nurses on the quality and the efficiency of the care for diabetic patients, and the third evaluates the impact of multi-professional group practices on the activity and the productive efficiency of GPs and on the utilization of ambulatory health care and by their patients. These researches question the relative weakness of the ambulatory health care regulation in France in terms of health care expenditure containment policies in comparison with that bearing on demand

  • Soins primaires et performance : de la variabilité des pratiques des médecins généralistes au rôle de l'organisation des soins
    HAL CCSD, 2014
    Co-Authors: Mousquès Julien
    Abstract:

    According to economic research, the general practitioner is considered as an agent that offered information and intellectual services in health to principals. Imperfect convergence between their objectives, like the presence of uncertainties and information asymmetries, lead the physician “to fix” the quantities, the effort and the quality of the care and services delivered. Based on three articles, this thesis aims at identifying the role of the characteristics of the general practitioners and of their practice organization, on activity performance. The first articles analyzes the determinants of the antibiotic prescription for acute Rhinopharyngitis variability, the second evaluates the impact of team working with nurses on the quality and the efficiency of the care for diabetic patients, and the third evaluates the impact of multi-professional group practices on the activity and the productive efficiency of GPs and on the utilization of ambulatory health care and by their patients. These researches question the relative weakness of the ambulatory health care regulation in France in terms of health care expenditure containment policies in comparison with that bearing on demand.La recherche économique considère le médecin généraliste comme un agent offrant à l’échange information et services intellectuels en santé à des principaux. L’imparfaite convergence entre leurs objectifs, comme la présence d’incertitudes et d’asymétries d’information, conduisent le médecin à « fixer » les quantités, l’effort fourni et la qualité des soins et services rendus. Cette thèse vise à identifier le rôle des caractéristiques des généralistes, de leur mode d’exercice ou d’organisation, sur la performance de leur activité, en s’appuyant sur trois articles. Le premier analyse les déterminants de la variabilité de prescription d’antibiotiques pour rhinopharyngite aiguë, le second évalue l’impact du travail en équipe avec des infirmières sur la qualité et l’efficience des soins pour les patients diabétiques, et le troisième évalue l’impact de l’exercice regroupé pluriprofessionnel sur l’activité et l’efficience productive des généralistes et l’efficience des recours aux soins ambulatoires de leurs patients. Ces travaux de recherche permettent d’interroger la faiblesse relative de la régulation de l’offre de soins ambulatoire en France en matière de politique de maîtrise de l’évolution des dépenses de santé en comparaison de celle portant sur la demande

  • Is the “practice style” hypothesis relevant for general practitioners? An analysis of antibiotics prescription for acute Rhinopharyngitis
    'Elsevier BV', 2010
    Co-Authors: Mousquès Julien, Renaud Thomas, Scemama Olivier
    Abstract:

    Le titre du working paper est différent : A Refutation of the Practice Style Hypothesis: the Case of Antibiotics Prescription by French General Practitioners for Acute RhinopharyngitisMuch research in France or abroad has highlighted the medical practice variation (MPV) phenomenon. There is no consensus on the origin of MPV between preference-centered approaches versus opportunities and constraints approaches. This study's main purpose is to assess the relevance of hypotheses which assume that physicians adopt a uniform practice style for their patients for each similar clinical decision in a context of medical decision with low uncertainty and professional practice with weak regulation. Multilevel models are evaluated: first to measure variability of antibiotics prescription by French general practitioners (GPs) for acute Rhinopharyngitis regarding clinical guidelines, and to test its significance in order to determine to what extent prescription differences are due to between or within GPs discrepancies; second, to prioritize its determinants, especially those relating to a GP or his/her practice setting environment, while controlling visit or patient confounders. The study was based on 2001 activity data, along with an ad hoc questionnaire, of a sample of 778 GP taken from a panel of 1006 computerized French GPs. We observed that a large part of the total variation was due to intra-physician variability (70%). It is patient characteristics that largely explain the prescription, even if GP or practice setting characteristics (location, level of activity, network participation, continuing medical education) and environmental factors (visit from pharmaceutical sales representatives) also exert considerable influence. This suggests that MPV are partly caused by differences in the type of dissemination of medical information and this may help policy makers to identify and develop facilitators for promoting better use of antibiotics in France and, more generally, for influencing GP practices when it is of interest

  • Soins primaires et performance : de la variabilité des pratiques des médecins généralistes au rôle de l'organisation des soins
    2026
    Co-Authors: Mousquès Julien, Joël Marie-eve
    Abstract:

    According to economic research, the general practitioner is considered as an agent that offered information and intellectual services in health to principals. Imperfect convergence between their objectives, like the presence of uncertainties and information asymmetries, lead the physician “to fix” the quantities, the effort and the quality of the care and services delivered. Based on three articles, this thesis aims at identifying the role of the characteristics of the general practitioners and of their practice organization, on activity performance. The first articles analyzes the determinants of the antibiotic prescription for acute Rhinopharyngitis variability, the second evaluates the impact of team working with nurses on the quality and the efficiency of the care for diabetic patients, and the third evaluates the impact of multi-professional group practices on the activity and the productive efficiency of GPs and on the utilization of ambulatory health care and by their patients. These researches question the relative weakness of the ambulatory health care regulation in France in terms of health care expenditure containment policies in comparison with that bearing on demand.Médecin généraliste; Variation des pratiques médicales; Travail en équipe; Exercice en groupe; Intégration verticale; Evaluation des résultats et processus; Consommation de soins; Expérimentation naturelle; Evaluation des politiques publiques; General practitioners; Medical practice variation; Team working; Group practicing; Vertical integration; Outcome and process assessment; Health care utilization; Natural experiment; Policy evaluation

Benavides G. Fernando - One of the best experts on this subject based on the ideXlab platform.

  • Distribución de la duración de la incapacidad temporal por contingencia común por diagnóstico médico (Cataluña, 2006-2008)
    SESPAS. Published by Elsevier España S.L., 2013
    Co-Authors: Delclós Jordi, Gimeno David, Torá Isabel, Martínez, José Miguel, Manzanera Rafael, Jardí Josefina, Alberti Constança, Benavides G. Fernando
    Abstract:

    ResumenPresentamos una herramienta sencilla y práctica que permite consultar la distribución habitual de la duración de la incapacidad temporal por contingencia común, según el diagnóstico médico. Para ello se analizaron 2.646.352 episodios de incapacidad temporal ocurridos en Cataluña y seguidos hasta el alta, entre 2006 y 2008, incorporados a un aplicativo. La duración mediana, dado que sigue una distribución asimétrica, fue de 9 días. Los trastornos musculoesqueléticos fueron el grupo diagnóstico más frecuente (22,5%) y las neoplasias tuvieron la duración mediana más larga (56 días). Los diagnósticos específicos más comunes fueron la diarrea-gastroenteritis (8,2%; mediana: 3 días) y la rinofaringitis aguda (5,2%; mediana: 4 días). La distribución de la duración de la incapacidad temporal en una población varía por diagnóstico y es asimétrica; la mayoría de los episodios duran mucho menos que la media. Esta información es importante para una mejor gestión, tanto clínica como administrativa, de la incapacidad temporal.AbstractWe present a simple and practical tool that allows the usual distribution of the duration of non-occupational sick leave to be determined by medical diagnosis. A total of 2,646,352 episodes of medically certified sick leave, registered by the Catalan Institute of Medical Evaluations for the period 2006-2008, were followed to closure and were entered into a spreadsheet. Given its asymmetric distribution, the median duration of sick leave was 9 days. Musculoskeletal disorders were the most frequent diagnostic group (22.5%), while neoplasms had the longest median duration (56 days). The most common specific diagnoses were diarrhea-gastroenteritis (8.2%; median: 3 days) and acute Rhinopharyngitis (5.2%; median: 4 days). The distribution of the duration of sick leave in a population varies by diagnosis and is asymmetric, with most episodes being much shorter than the mean duration. This finding is important for better clinical and administrative management of sick leave episodes

Benoît Arnould - One of the best experts on this subject based on the ideXlab platform.