Skip to Main content Skip to Navigation
Master Thesis

Accès aux soins à la sortie d’une hospitalisation de court séjour après un premier épisode d’AVC en Guyane et facteurs associés : analyse de cohorte prospective de 2011 à 2014

Abstract : Introduction: The French "health law" of January 26th, 2016 emphasized the importance of the fight against social and territorial health inequalities in France. French Guiana, a French territory located on the north-east of the South American continent, turns out to be quite in equal regarding strokes. This article attempts to evaluated access to health care after discharge from a short-stay hospitalization in comparison with the metropolitan France. It also analyses the clinical, personal and environmental factors involved in the post-stroke orientation decisions, to show case whether there are inequalities and what to implement to address this challenge. Material and Method: 301 patients prospective cohort analysis from the July 2011 to June 2014 INDIA study, encompassing main Guianese hospitals from Cayenne, Kourou and St Laurent du Maroni. Primary outcome measure is the exit orientation after a first stroke, between institutional care, health home care and returning home. After descriptive and bivariate analyzes, a multivariate analysis by multinomial logistic regression study the orientation variable in functions of explanatory variables. Results: Out of the 206 patients included, transferrates after a first stroke in Guyana were, 38.4% to institutional care, 5.8% to health home care and 55.8% to returning home without care. The factors identified as impacting this orientation in French Guiana were, functional severity, medical institutions involved, age, study level, precariousness global score and frequency of consultations with a doctor. Conclusion: French Guiana’s statistics on the topic reveal similar transfer rates with regards to metropolitan France. The study of the factors associated with the post-stroke orientations reflects intra-territorial disparities with regards to access to care. It also helps understanding adaptations to implement to address the issue. Efforts to further understand and minimize disparities in French Guyana are particularly crucial. Still, complementary analyses should be run in other French regions(using INDIA’s datas), using the same methodology and to provide a more accurate comparison.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [123 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02265830
Contributor : Pointe À Pitre Bhu <>
Submitted on : Tuesday, December 3, 2019 - 7:57:50 PM
Last modification on : Monday, July 20, 2020 - 6:46:02 PM
Long-term archiving on: : Wednesday, March 4, 2020 - 12:28:11 PM

File

ThEse__Tolle_Adrien.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02265830, version 1

Collections

Citation

Adrien Tolle. Accès aux soins à la sortie d’une hospitalisation de court séjour après un premier épisode d’AVC en Guyane et facteurs associés : analyse de cohorte prospective de 2011 à 2014. Médecine humaine et pathologie. 2019. ⟨dumas-02265830⟩

Share