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Master Thesis

Milieu rural, semi-rural ou urbain : confirmation d’indicateurs quantitatifs permettant de définir le milieu d’exercice des médecins généralistes

Abstract : Introduction: to define an urban, rural or semi-rural practice, the data currently used are those of INSEE (National Institute of Statistics and Economic Studies). Dr. Coutrix's thesis showed that these definitions were not suitable for general practitioners, who define their type of exercise according to several criteria: distance to an emergency service, population density, more or less extended activity in the context primary care, and typology of the territory. She proposed a tool to help determine the practice environment of general practitioners. The main objective of this study is to quantitatively confirm these indicators of practice environment determination of general practitioners, to confirm them. Secondly, to determine the limits of this tool and to define the semi-rural environment. Method: we have conducted a quantitative study by telephone questionnaire on 280 general practitioners in Gironde and in the Landes, randomly selected, between June and August 2019. Results: 187 general practitioners answered the telephone questionnaire. Following a quantitative statistical analysis by chi2 test, 6 criteria showed an association between the working environment and the practice of doctors: carrying out visits more than 10 kilometers from the office, practicing a medicine with a specific orientation, obtaining a consultation with a pulmonologist in a week, participation in the permanence of care from 8 p.m. to midnight, plastering or splinting in the office, and consultation slots dedicated to same-day emergencies. These criteria were supplemented by the distance to the emergency room, population density and typology of the territory in order to develop the tool. Conclusion: the tool for determining the practice environment of general practitioners includes 6 criteria concerning primary care and 3 geographic criteria. The tool applied to our population has a sensitivity of 70.6% to define the type of practice. Using INSEE data, only 45.9% of doctors identified themselves with the definition of their type of practice. This tool would need to be tested on a large sample of general practitioners.
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Master Thesis
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Submitted on : Friday, October 23, 2020 - 3:50:36 PM
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Marie-Emmanuelle Corfias. Milieu rural, semi-rural ou urbain : confirmation d’indicateurs quantitatifs permettant de définir le milieu d’exercice des médecins généralistes. Médecine humaine et pathologie. 2020. ⟨dumas-02976752⟩

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