Déterminants des coûts du passage à l’insuline en France chez le patient diabétique de type 2 : quelles pistes d’optimisation ? (notice n° 1004136)
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| control field | 20250125134837.0 |
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| Language code of text/sound track or separate title | fre |
| 042 ## - AUTHENTICATION CODE | |
| Authentication code | dc |
| 100 10 - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Hanaire, Hélène |
| Relator term | author |
| 245 00 - TITLE STATEMENT | |
| Title | Déterminants des coûts du passage à l’insuline en France chez le patient diabétique de type 2 : quelles pistes d’optimisation ? |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Date of publication, distribution, etc. | 2016.<br/> |
| 500 ## - GENERAL NOTE | |
| General note | 90 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Introduction : Les coûts liés au diabète de type 2 (DT2) et à ses complications sont en progression constante en France. Ces coûts sont particulièrement élevés chez certains patients traités par insuline. L’étude de leur dynamique avant et après l’initiation de l’insulinothérapie permet d’appréhender les raisons de cette situation. Méthode : Une analyse des données de l’Échantillon généraliste de bénéficiaires de l’Assurance maladie a identifié les patients DT2 ayant bénéficié de l’initiation d’un traitement par insuline en 2011 et 2012. Les consommations de soins ont été évaluées et comparées sur trois années avant et une année après cette initiation. Résultats : L’analyse a porté sur 1 233 patients DT2 du régime général. Le passage à l’insuline s’accompagne d’une augmentation du montant moyen annuel de soins présentés au remboursement, d’environ 3 650 € pour atteindre 11 000 €/an (schéma avec insuline basale seule). Trois postes représentent 86 % de l’augmentation observée (hospitalisations 29 %, soins infirmiers 44 %, dispositifs médicaux 13 %). L’augmentation est surtout importante chez les patients bénéficiant de soins infirmiers réguliers sur une longue durée (> 90 jours) après l’initiation et dans une moindre mesure chez les patients hospitalisés. Conclusion : L’augmentation des coûts ne peut pas être imputée uniquement à la prescription d’insuline. On peut penser que toute initiative visant à favoriser l’acquisition de l’autonomie du patient pourrait réduire les coûts observés après le passage à l’insuline si elle est adaptée à la nature de la demande, au profil médico-social du patient, à son parcours et aux ressources médicales qui l’entourent. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Determinants of the cost of initiation of insulin therapy type 2 diabetic patients in France: possible approaches to optimization Introduction: The costs related to diabetes and related complications are steadily rising in France. Costs are particularly high among patients treated with insulin. A dynamic analysis of the costs before and after initiation of insulin therapy helps to elucidate the reasons for this situation. Method: Analysis of data from the “Échantillon Généraliste des Bénéficiaires”, a permanent representative sample of the population covered by the French compulsory health insurance, was conducted to identify T2DM patients initiating insulin therapy in 2011 and 2012. Healthcare consumption was assessed over a 3-year period before initiation of insulin therapy and was compared to that of the following year. Results: The analysis included 1,233 T2DM patients. The switch to insulin was accompanied by a €3,650 increase in average annual total costs to reach €11,000/year (for basal insulin therapy). Three items represented 86% of the observed increase of total cost (hospitalization: 29%, nursing care: 44%, medical devices: 13%). The increase was mainly observed in patients receiving long-term (more than 90 days) regular nursing care and, to a lesser extent, among hospitalized patients. Conclusion: Increased costs cannot be exclusively attributed to the consequences of insulin prescription. Any initiative designed to accelerate acquisition of patient autonomy would be likely to reduce the costs observed after switching to insulin, provided this initiative is adapted to the patient’s health profile, diabetes history and available medical resources. |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | insuline |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | base de données |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | diabète de type 2 |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | coûts |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | France |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | costs |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | database |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | type 2 diabetes mellitus |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | insulin |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | France |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Attali, Claude |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Lecointre, Brigitte |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Fraysse, Martial |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Gouet, Didier |
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| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Babel, Marie-Renée |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Charbonnel, Bernard |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Sarkozy, François |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Gourmelen, Julie |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Detournay, Bruno |
| Relator term | author |
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| Note | Santé Publique | 28 | 6 | 2016-12-19 | p. 781-789 | 0995-3914 |
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| Uniform Resource Identifier | <a href="https://shs.cairn.info/revue-sante-publique-2016-6-page-781?lang=fr&redirect-ssocas=7080">https://shs.cairn.info/revue-sante-publique-2016-6-page-781?lang=fr&redirect-ssocas=7080</a> |
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