Biomedical subjects

Valentin Daucourt

Publications and source records attributed to Valentin Daucourt.

4 recordsLinked to original sources

PubMed2005

Cost-minimization analysis of a wide-area teleradiology network in a French region.

OBJECTIVE: The objective of our study was to perform a cost-minimization analysis of a wide-area teleradiology network. DESIGN: A prospective analysis of all transmissions over 1 year (data transmitted at the time of the remote consultation, and health outcomes of patients from medical record). INTERVENTION: The inter-hospital teleradiology network of the Aquitaine area (RIHRA) is a telemedicine system enabling the management of remote emergencies and elective radiology consultations. MAIN OUTCOME MEASURE: A cost-minimization study enabled a comparison of care procedures following the use of the network with those which would have been implemented without the network. The outcome measures of effectiveness were the transfers, hospitalizations, and consultations avoided or added. Fixed and variable costs were estimated. RESULTS: Among the 664 transmissions included in the study, 562 (85%) were performed in emergency and 102 (15%) for elective (non-emergency) cases. In emergency, 48% of transfers were avoided. For elective teleconsultations, a transfer was avoided for 37% of the patients and hospitalization for 12%. An extra consultation occurred after remote consultation for 2% of the patients. Annual saving can be estimated at 102,779 EUR for the Aquitaine area. CONCLUSIONS: This study underlines the efficiency of an inter-hospital teleradiology network. A qualitative evaluation of the impact of the use of the system should be carried out to improve technical and organizational operations.

Cost Control↗

PubMed2005

Evaluation of the benefits for the patient arising from an inter-hospital teleradiology network in a French administrative area.

We conducted a prospective study of the teleradiology network which connects 15 hospitals in the Aquitaine area. All transmissions sent over a one-year period were examined (data transmitted at the time of the remote consultation and health outcomes of patients from their medical records). For emergency cases, the main outcome measure of effectiveness was the proportion of avoided transfers. For non-emergency cases, the main outcome measure of effectiveness was the proportion of transfers, hospitalizations and consultations avoided. There were 737 transmissions, of which 664 (90%) met the inclusion criteria. Of these, 562 (85%) were for emergency care and 102 (15%) for non-emergency care. In emergency care, the pathologies most often associated with a remote consultation were cerebral pathologies (88%) and traumatic spinal pathologies (8%); the proportion of avoided transfers was 48%. In non-emergency care, the specialties most often concerned with remote consultations were neurology/neurosurgery (36%), cardiology and pulmonary diseases (17%) and gastroenterology (14%). Transfer was avoided for 37% of the patients and hospitalization for 12%. An additional consultation occurred after remote consultation for 2% of the patients. The results confirm the effectiveness of an inter-hospital teleradiology network.

Adolescent↗

PubMed2003

Results of the first 100 accreditation procedures in France.

PURPOSE: To identify the areas of needed improvement that were most frequently identified in the first 100 accredited hospitals by the French Accreditation College (FAC) according to the standards manual. To compare the outcomes of accreditation procedures according to the status and size of the accredited hospitals. DATA SOURCES: We analyzed the first 100 summaries of accreditation reports available on the website of the Agence Nationale d'Accréditation et d'Evaluation en Santé (ANAES). DATA EXTRACTION: Data were collected on hospitals, accreditation processes, and outcomes (decisions of the FAC). For each decision, we assessed the relationship with accreditation manual criteria, and analyzed their distribution by chapter. RESULTS: of data synthesis. Among the 100 accredited hospitals (40 public, 43 private, 17 mixed), nine were accredited without recommendations for improvement, 47 with recommendations, 40 with reservations, and four with major reservations. All of them received requests for improvement. No significant difference was found concerning the FAC decisions according to status and size of hospitals, although there was a trend that the larger the hospital, the more numerous and more serious the decisions of the FAC. The main topics addressed by decisions were those given high priority by the FAC (information given to patients and its traceability on patient records, and signing of prescriptions for medication). CONCLUSION: Despite wide heterogeneity in the summaries on accreditation and in FAC decision-making, this study provides an initial insight into common quality defects and ANAES priorities for hospitals in France.

Accreditation↗

PubMed2003

A multicenter cluster randomized controlled trial of strategies to improve thyroid function testing.

OBJECTIVES: This project aimed to compare the independent and combined effectiveness of two implementation interventions of guidelines for ordering thyroid function tests: a Memorandum Pocket Card (MPC) and a Test Request Form (TRF). RESEARCH DESIGN: Intervention groups were wards. The study used an experimental 2*2 factorial design with matching hospitals according to size and activity and wards according to preintervention appropriateness for test ordering. Four ward groups were established: the dual intervention group, the order form group, the pocket card group and the control group. Physicians in all groups received guidelines and were invited to a local information meeting. MEASURES: The main outcome measure of effectiveness was the Guideline Conformity Rate (GCR). RESULTS: Six hospitals participated in the study (two middle-sized hospitals, two small-sized hospitals and two psychiatric hospitals). A total of 1412 orders for thyroid function tests were collected. GCR was 78% in the dual intervention group, 83% in the order form group, 73% in the pocket card group and 62% in the control group. The interaction between TRF and MPC was not significant (beta = -0.70; P = 0.21). Compared with simple information, TRF was effective in increasing GCR (OR, 2.65; 95% CI, 1.52-4.62), unlike MPC (OR, 1.28; CI, 0.75-2.19). CONCLUSIONS: Using a robust design, our study shows the greater effectiveness of TRF than MPC and their association in implementing thyroid function test guidelines.

Adult↗