PMID- 35662533
OWN - NLM
STAT- MEDLINE
DCOM- 20220712
LR  - 20220712
IS  - 1872-6054 (Electronic)
IS  - 0168-8510 (Linking)
VI  - 126
IP  - 8
DP  - 2022 Aug
TI  - Does integrated care mean fewer hospitalizations? An evaluation of a French field 
      experiment.
PG  - 786-794
LID - S0168-8510(22)00122-1 [pii]
LID - 10.1016/j.healthpol.2022.05.009 [doi]
AB  - This study aims to evaluate the impact of an experimental healthcare policy on 
      hospital use among elderly patients. From 2015 to 2017, French public authorities 
      implemented an integrated care model, the Digital Health Territories (Territoire 
      de Soins Numerique (TSN)) programme designed to improve healthcare coordination 
      and sustain the use of health information (HI) technologies. The TSN programme 
      was expected to reduce hospital healthcare utilization. In the Aquitaine region, 
      the TSN programme was implemented in part of the Landes district and primarily 
      consisted of the creation of a support platform (PTA). Part of the Lot-et-Garonne 
      district was chosen as a "control area" due to its similarities to the 
      experimental district in terms of the population structure and healthcare supply 
      characteristics. In the control area, no integrated care model innovation was 
      implemented over the study period. Using claims data from the French National 
      Health Insurance (Systeme National d'Information Inter-Regimes de l'Assurance 
      Maladie (SNIIRAM)), the healthcare utilization of the populations living in the 
      experimental and control areas was tracked from 2012 to 2017. To estimate the 
      impact of the TSN programme on three hospitalization outcomes, we used a 
      combination of matching and difference-in-differences (DiD) approaches. The TSN 
      programme shows a significant but weak negative impact on emergency department 
      (ED) visits and no significant impact on 30-day re-hospitalizations (R30) or 
      potentially avoidable hospitalizations (PAHs).
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Gaillard, Aurelie
AU  - Gaillard A
AD  - Universite de Bordeaux, Bordeaux Population Health, Inserm U1219, [EMOS], 33000 
      Bordeaux, France. Electronic address: aurelie.gaillard@univ-poitiers.fr.
FAU - Garcia-Lorenzo, Borja
AU  - Garcia-Lorenzo B
AD  - Universite de Bordeaux, Bordeaux Population Health, Inserm U1219, [EMOS], 33000 
      Bordeaux, France; Assessment of Innovations and New Technologies Unit, Hospital 
      Clinic, University of Barcelona, Barcelona, Catalonia, Spain. Electronic address: 
      bgarcia@kronikgune.org.
FAU - Renaud, Thomas
AU  - Renaud T
AD  - Universite de Bordeaux, Bordeaux Population Health, Inserm U1219, [EMOS], 33000 
      Bordeaux, France. Electronic address: thomas.renaud@dauphine.psl.eu.
FAU - Wittwer, Jerome
AU  - Wittwer J
AD  - Universite de Bordeaux, Bordeaux Population Health, Inserm U1219, [EMOS], 33000 
      Bordeaux, France. Electronic address: jerome.wittwer@u-bordeaux.fr.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220521
PL  - Ireland
TA  - Health Policy
JT  - Health policy (Amsterdam, Netherlands)
JID - 8409431
MH  - Aged
MH  - Databases, Factual
MH  - Delivery of Health Care
MH  - Emergency Service, Hospital
MH  - *Hospitalization
MH  - Humans
MH  - *National Health Programs
OTO - NOTNLM
OT  - Elderly
OT  - Emergency department visits
OT  - Field experiment
OT  - Health policy evaluation
OT  - Integrated care
EDAT- 2022/06/07 06:00
MHDA- 2022/07/14 06:00
CRDT- 2022/06/06 13:39
PHST- 2021/07/09 00:00 [received]
PHST- 2022/04/09 00:00 [revised]
PHST- 2022/05/19 00:00 [accepted]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
PHST- 2022/06/06 13:39 [entrez]
AID - S0168-8510(22)00122-1 [pii]
AID - 10.1016/j.healthpol.2022.05.009 [doi]
PST - ppublish
SO  - Health Policy. 2022 Aug;126(8):786-794. doi: 10.1016/j.healthpol.2022.05.009. 
      Epub 2022 May 21.