Evidence map›Paper›PMID 32474715›Full record

ArticleInternational journal of public health2020

Forgoing health care under universal health insurance: the case of France.

Anne-Laure Feral-Pierssens, Claire Rives-Lange, Joane Matta, Victor G Rodwin, Marcel Goldberg, Philippe Juvin, Marie Zins, Claire Carette, Sebastien Czernichow

Abstract read
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In one paragraph

Article in International journal of public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
5.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 29 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 4 countries.

Anne-Laure Feral-PierssensPopulation-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France. anne-laure.feral-pierssens@aphp.fr.ORCID http://orcid.org/0000-0003-0461-5611
Claire Rives-LangeAssistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.
Joane MattaPopulation-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France.
Victor G RodwinDépartement Epidémiologie et Systèmes de Santé, UniSanté, Lausanne, Switzerland.
Marcel GoldbergPopulation-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France.
Philippe JuvinAssistance Publique Hôpitaux de Paris, Emergency Department, Georges Pompidou European Hospital, Paris, France.
Marie ZinsPopulation-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France.
Claire CaretteAssistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.
Sebastien CzernichowAssistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.
Inserm · FRCentre universitaire de médecine générale et santé publique, Lausanne · CHUniversité Paris Cité · FR

Funding

Commissariat Général à l'Investissement ANR-11-INBS-0002
6 · The paper itself

Abstract

objectivesWe investigate the reliability of a survey question on forgone healthcare services for financial reasons, based on analysis of actual healthcare use over the 3-year period preceding response to the question. We compare the actual use of different health services by patients who report having forgone health care to those who do not.

methodsBased on a prospective cohort study (CONSTANCES), we link survey data from enrolled participants to the Universal Health Insurance (UHI) claims database and compare use of health services of those who report having forgone health care to controls. We present multivariable logistic regression models and assess the odds of using different health services.

resultsCompared to controls, forgoing care participants had lower odds of consulting GPs (OR = 0.83; 95% CI 0.73, 0.93), especially specialists outside hospitals (gynecologists: 0.74 (0.69, 0.78); dermatologists: 0.81 (0.78-0.85); pneumologists 0.82 (0.71-0.94); dentists 0.71 (0.68, 0.75)); higher odds of ED visits (OR = 1.25; 95% CI 1.19, 1.31); and no difference in hospital admissions (OR = 1.02; 95% CI 0.97, 1.09). Participants with lower occupational status and income had higher odds of forgoing health care.

conclusionsThe perception of those who report having forgone health care for financial reasons is consistent with their lower actual use of community-based ambulatory care (CBAC). While UHI may be necessary to improve healthcare access, it does not address the social factors associated with the population forgoing health care for financial reasons.

Indexed as

AdolescentAdultAgedBayes TheoremFemaleFranceHealth Services AccessibilityHumansLogistic ModelsMaleMiddle AgedOffice VisitsPatient Acceptance of Health CareProspective StudiesReproducibility of ResultsSurveys and QuestionnairesAccess to careSocial deprivationUniversal Health Insurance (UHI)Unmet healthcare needs

Identifiers

PMID32474715
OpenAlexW3029464054

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.