Treść książki

Przejdź do opcji czytnikaPrzejdź do nawigacjiPrzejdź do informacjiPrzejdź do stopki
Costsandfinancesinhospitals
19
In2008,thechallengeinFranceandothersuchcountriesistotakeintoaccount
thissocialdimensioninthereformedsystembudget.TheGHSsystemcanneither
nanciallycoverthepatients,personalsocialdimensionsnordetermineaspecific
budgetnecessaryinresponsetotheseparticularneeds,whicharenotmainlymedi-
callybased.ThereiscurrentlynoaidfromtheGHStariffs13,14,15totakenancial
accountofthepersonalsocialdimensionofapatient16ortoallowadiscretionaryor
specificbudgettomeettheseparticularneeds.
Ouraimistodesignatooltomeasuresocialdisability(notexclusivelyitsper-
ception)ofpatientsinapublichospitaltolearn:1)thedisabilitydistributionand
particularneedslinkedtothesocialdisability,aswellasthepatients,medicalneeds;
2)whetherornottheseneedsmobilizeadditionalfundingresources;3)theextrare-
sourcesthatcanbecoveredbythepublichospitalsothatitfulfilsitspublicservice
mission.TheGHSassociatedwithsocialdisabilityindicators
17,18,19,20
wouldprovide
betterknowledgeonpatientsadmittedtoapublichospitalandontheaveragelength
ofstayandnumberofadditionalhospitaldays.Ourobjectiveistoproposeamethod
ofestimatingpatients,socialdisabilityinordertohaveitsmeasurementandtoinclude
thecostsnotfundedbypublicauthoritiesandtheadditionalbudgettobeallocated.
TheFrenchcasestudiedhereshouldbeanexampleforallEuropeancountries
whichmeetthisparticularproblemofdealingwithlongerhospitalstaysresulting
frompersonalsocialdimensionsofapatient.
1.1.2.METHODS.ANINVESTIGATIVESTRATEGYBASEDONFOUR
COMPLEMENTARYEVALUATIONS
1)Socialdisability:Theevaluationofsocialdisabilitywasconductedwithan
anonymousquestionnaire[Table1]basedontheBorkowskietal.21andVilleneuve22
works.CompiledbystatisticiansofINSEE(InstitutNationaldelaStatistiqueetdes
13C.Segouin,P.H.Bréchat,L.Lebrun,F.Sahraoui(2006),LesrévolutionsduPMSIetdela
T2A:Bilansetperspectives,[in:]P.H.Bréchat,E.Salines,C.Segouin(dir.),Médecinsdesanté
publique,ÉditionsENSP,Rennes,p.212–223..
14C.Mathy,M.Bensadon(2002),Lesurcoûtdel’hospitalisationdespatientsprécaires,JEM.
20,p.263–278.
15C.Segouin,P.H.Bréchat,L.Lebrun,F.Sahraoui(2006),ThenewFrenchhospitalfinancing
system:challengesfor2006,PresseMed.35,p.565–567.
16P.H.Bréchat,A.Bérard,C.Magnin-Feysot,C.Segouin,D.Bertrand(2006),Consumersand
healthpolicies:reportsandperspectives,SantePublique18,p.245–262.
17J.L.Borkowski,L.Kasparian(1991),Construiredesindicateursd’inégalitésEnquête
«Étudedesconditionsdevie»1986–1987,DocumentdetravailF9106.INSEE,Paris.
18A.Villeneuve(1991),LamesuredesinégalitéssoussonaspectmultidimensionnelEnquête
«Étudedesconditionsdevie»1986–1987,DocumentdetravailF9105.INSEE,Paris.
19Ibidem.
20Ibidem.
21J.L.Borkowski,L.Kasparian(1991),Construiredesindicateursd’inégalitésEnquête
«Étudedesconditionsdevie»1986–1987,DocumentdetravailF9106.INSEE,Paris.
22A.Villeneuve(1991),LamesuredesinégalitéssoussonaspectmultidimensionnelEnquête
«Étudedesconditionsdevie»1986–1987,DocumentdetravailF9105.INSEE,Paris.