Journal of epidemiology and population health最新文献

{"title":"Evaluating quality of care and patient safety with ICD-11: Opportunities for the French National Health Data System (SNDS).","authors":"Bastien Boussat, Laurent Boyer, Catherine Quantin, Danielle A Southern, William A Ghali, Sophie Guéant, Fabrice Danjou, Yasmine Mokaddem, Grégoire Mercier, Antoine Duclos","doi":"10.1016/j.jeph.2026.203372","DOIUrl":"10.1016/j.jeph.2026.203372","url":null,"abstract":"<p><p>Administrative health databases are widely used to evaluate healthcare quality and patient safety at the population level. In France, the French National Health Data System (SNDS) integrates hospital discharge data coded using the 10th revision of the International Classification of Diseases (ICD-10), enabling large-scale analyses of care pathways, outcomes, and health system performance. The transition to the 11th revision of the International Classification of Diseases (ICD-11) introduces structural and digital features that may modify how routinely collected data can be analyzed for quality and safety purposes. This article describes how selected characteristics of ICD-11 could influence the use of SNDS for evaluating quality of care and patient safety. Four dimensions are examined: clinical representation through postcoordination and extension codes; the three-part model for describing healthcare-related adverse events; coding of diagnosis timing in relation to hospital admission and procedures; and risk adjustment using comorbidities, severity, and sequelae. For each dimension, practical coding examples are used to illustrate potential analytical implications for population-based indicators. The analysis suggests that ICD-11 enables more explicit representation of clinical context, healthcare-related events, and temporal information within administrative data. These features may support more precise construction and interpretation of quality and safety indicators derived from the SNDS. The extent to which these possibilities translate into measurable improvements will depend on implementation conditions, including coding practices, training, and the integration of ICD-11 into existing information systems and analytical frameworks.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203372"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the 'historical' National Health Data System to study infectious diseases.","authors":"Jean-Marie Loreau, Aurélie Mayet, Sophie Tchakamian, Guillaume Desjeux","doi":"10.1016/j.jeph.2026.203393","DOIUrl":"10.1016/j.jeph.2026.203393","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying infectious diseases through French National Health Data System (SNDS), a medico-administrative database, presents specific challenges due to their intrinsic characteristics, such as curability or highly variable prevalence. This study assesses the capacity of the SNDS to accurately identify pathologies and to ensure follow-up of affected individuals.</p><p><strong>Methods: </strong>The study focuses on \"Certain infectious and parasitic diseases\" (ICD-10 Chapters A and B). Eligible conditions were required to correspond to a three-character ICD-10 sub-chapter accounting for fewer than 10,000 discharge summaries (MCO) within the Programme for Medicalisation of Information Systems (PMSI) between 2006 and 2024. It evaluates the influence of different indicators, such as the extraction sources, the quality of record linkage using the national registration number (NIR) and the follow-up of subjects.</p><p><strong>Results: </strong>A total of 155,419 individuals across 77 selected ICD-10 sub-chapters were included. On average, 6% of individuals were non-linkable. Subjects identification was primarily achieved through the beneficiary registry (87%). By sub-chapter, the PMSI was the main source of identification, with an average of 95%. The average proportion of individuals still present in the SNDS five years after the initial occurrence was 58%.</p><p><strong>Discussion: </strong>These findings are closely linked to the core concept of the SNDS, which relies on health insurance data collection. Data linkage is fundamentally tied to insurance affiliation; consequently, while high-prevalence tropical or sub-tropical diseases are identifiable, longitudinal tracking is more challenging to achieve.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203393"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On using national health data responsibly.","authors":"Bastien Boussat, Stéphane Sanchez, Laurent Boyer","doi":"10.1016/j.jeph.2026.203390","DOIUrl":"10.1016/j.jeph.2026.203390","url":null,"abstract":"","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203390"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of the French national health data system to research on mental disorders: A public health perspective - insights from the mental disorders working group of the ReDSiam network.","authors":"Coralie Gandré, Amaria Baghdadli, Magali Coldefy, Jonathan Cottenet, Fanny Duchaine, Maude Espagnacq, Jean-Baptiste Hazo, Fabrice Jollant, Mélanie Loiseau, Julie Loubersac, Aurélie Mayet, Anne Penneau, Marie-Christine Picot, Baptiste Pignon, Philippe Pirard, Jonathan Roux, Esther Touitou-Burckard, Catherine Quantin","doi":"10.1016/j.jeph.2026.203365","DOIUrl":"10.1016/j.jeph.2026.203365","url":null,"abstract":"<p><strong>Background: </strong>Mental disorders represent a major public health challenge, exerting significant pressure on health systems and societies worldwide. Addressing persistent knowledge gaps in their epidemiology and adequate care requires robust population-based data. This article illustrates how a large-scale health claims database can advance research on mental disorders and inform public health decision-making, using the French national health data system (SNDS) as an example.</p><p><strong>Methods: </strong>We conducted a thematic mapping of studies that used the SNDS to investigate mental disorders from a public health perspective. Relevant studies were identified through the collective expertise of the Mental Disorders Working Group within the ReDSiam network, a national expert group dedicated to developing and validating algorithms for use within the SNDS. Sources included presentations at the group meetings, scientific conferences, and existing literature.</p><p><strong>Results: </strong>First, the SNDS, particularly when combined with prospective cohorts, enables large-scale research on factors associated with the onset of mental disorders, ranging from early-life exposures to adverse life events. Second, it supports the comprehensive epidemiological surveillance of these conditions by facilitating the development of refined detection algorithms and enabling the monitoring of temporal and spatial trends. Third, it allows advanced analyses of care trajectories for individuals with mental disorders, adopting a whole-system approach capturing pathways across services.</p><p><strong>Conclusion: </strong>The SNDS offers unprecedented opportunities to advance public health research on mental disorders. Despite limitations, notably regarding clinical and socio-economic information, ongoing methodological advances and broader data integration will further strengthen its contribution to guiding prevention and care strategies in France.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203365"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ReDSiam network: cataloging, developing, and evaluating algorithms to identify pathologies in the French National Health Data System (SNDS).","authors":"Émeline Heyndrickx-Gallin, Antoine Duclos, Sofiane Kab, Javier Nicolau, Catherine Quantin, Antoine Rachas, Marcel Goldberg","doi":"10.1016/j.jeph.2026.203375","DOIUrl":"10.1016/j.jeph.2026.203375","url":null,"abstract":"","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203375"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to value the full cost of medical consultations in France? Results from MOVIE project.","authors":"Christel Castelli, Michael Mounié, Nadège Costa","doi":"10.1016/j.jeph.2026.203385","DOIUrl":"10.1016/j.jeph.2026.203385","url":null,"abstract":"<p><p>In France, the lack of standardized unit cost data is a major barrier to high-quality, easily comparable health economic evaluations. The objective of the MOVIE project was to standardize costing methods and provide accurate estimates of unit costs for French healthcare services. More than 200 million general practitioner (GP) consultations were recorded in France in 2021, at a total billed cost of €10.5 billion - approximately 80% of which was covered by the state health insurance system. In the same year, there were 125 million consultations with specialist physicians, for a total billed cost of €13.9 billion. The baseline per-consultation tariff was €25 for a GP and €31.5-€58.5 for a specialist; however, these figure excluded additional costs and thus were potentially underestimated. The MOVIE project took account of consultation fees, procedure fees, the patient's out-of-pocket payments, and annual physician incentives linked to quality, prevention, and public health activities. In an analysis of a representative 2% sample (the Échantillon du Système National des Données de Santé) of the French National Health Database, the mean GP consultation cost was €39.8 but could amount to as much as €75.1 when additional medical procedures were included. The cost of a consultation with a specialist was €66.1 on average but ranged from €40.2 (for an oncologist) to €104.3 (for a neurologist). Cost variability was driven by the type of consultation, additional procedures, the medical specialty, the practice setting, the patient's age, and the geographic region. By capturing all the relevant cost components, this MOVIE study (i) provides the first comprehensive, validated assessment of medical consultation costs in France (enabling more accurate, more easily comparable economic evaluations) (ii) supports healthcare policy, budget impact analyses, and clinical trial modeling, and (iii) highlights key cost drivers and regional differences.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203385"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey-french national health data system (SNDS) linkage: A win-win methodology for longitudinal studies, algorithm validation, and real-world evidence.","authors":"Sofiane Kab, Marcel Goldberg","doi":"10.1016/j.jeph.2026.203391","DOIUrl":"10.1016/j.jeph.2026.203391","url":null,"abstract":"<p><strong>Background: </strong>Integrating granular personal and clinical data with large-scale administrative records is a frontier in modern public health. In France, linking national epidemiological surveys with the National Health Data System (SNDS)-one of the world's most exhaustive administrative databases-offers a transformative \"win-win\" methodology to overcome self-reporting biases and loss to follow-up.</p><p><strong>Methods: </strong>This paper analyzes the architectural and methodological frameworks of data linkage to SNDS in France, distinguishing between deterministic linkage (via the National Identification Number) and probabilistic approaches. We examine major national integrations, including the prospective Constances cohort, cross-sectional surveys or clinical cohorts, and administrative cohorts like EDP-Santé.</p><p><strong>Results: </strong>Linkage significantly enhances data utility by cross-referencing objective healthcare consumption with socio-economic, environmental, and behavioral health determinants. Beyond data enrichment, this synergy provides a robust methodological platform for the validation of identification algorithms, allowing researchers to calculate sensitivity and specificity against clinical \"Gold Standards.\" We highlight how these linked datasets facilitate complex longitudinal studies on social health inequalities and care pathways that are unattainable through isolated sources.</p><p><strong>Conclusion: </strong>Survey-SNDS linkage is a \"win-win\" process that has become the foundational standard for high-impact research in France. By maximizing the utility of national data assets, this methodology provides a replicable model for global real-world evidence (RWE) generation and public health policy evaluation.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 2","pages":"203391"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated determinants of smoking among immigrants and descendants of immigrants in France in the Covid-19 period.","authors":"Patricia MacNeil, Lionel Pourtau, Gwenn Menvielle, Simon Ducarroz","doi":"10.1016/j.jeph.2026.203389","DOIUrl":"https://doi.org/10.1016/j.jeph.2026.203389","url":null,"abstract":"<p><strong>Background: </strong>Previous findings have indicated that immigrant smoking behaviour differs from that of the native-born population. However, certain factors identified as predictors among the general populations, such as social norms and religion, are seldom examined among immigrants. This study aims to identify demographic, social norm and religion-related determinants associated with smoking among immigrants and descendants of immigrants in the French context.</p><p><strong>Methods: </strong>A sample of immigrants and descendants of immigrant(s) in France completed a cross-sectional online survey in 2020. Data was collected on factors hypothesized to be determinants of smoking. Associations between selected covariates and smoking were quantified through multivariable logistic regression analyses. Comparability of the study sample with the source population was also assessed.</p><p><strong>Results: </strong>Sex-specific immigrant and descendant analyses revealed variation between these groups in demographic and other predictors of smoking. High odds of smoking were noted among male and female descendants of Middle Eastern and other North African origin, descendants who indicated that not smoking had negative social consequences and among female immigrants with an insufficient health literacy status. Lower odds of smoking were noted among female descendants of immigrants who practiced a religion.</p><p><strong>Conclusion: </strong>These findings underlined the need for the inclusion of seldom-studied key determinants of smoking such as religion and social norm factors in development of smoking prevention and cessation programs that target immigrants and descendants of immigrants in France.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 3","pages":"203389"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transportability in healthcare research: A review of practical applications and statistical methods.","authors":"Claire Leboucher, Sylvaine Barbier, Clément François, Malgorzata Panek, Alex Turner, Laurent Boyer","doi":"10.1016/j.jeph.2026.203388","DOIUrl":"https://doi.org/10.1016/j.jeph.2026.203388","url":null,"abstract":"<p><strong>Background: </strong>Transportability assesses if study results (from Randomized Controlled Trials (RCTs) or Real-World Data (RWD)) can be applied to different target populations, including other real-world settings, geographic regions, or specific subgroups. Although Health Technology Assessment agencies advocate for transportability to optimize resources and improve decision-making, there is little guidance on specific methods to achieve it. This review aims to identify statistical methods to achieve transportability applied from RCTs or RWD to real-world populations.</p><p><strong>Method: </strong>A literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified articles by searching MEDLINE and Embase until 18th October 2023. The review focused on studies describing and applying statistical methods for transporting evidence from RCTs to real-world populations and from RWD to other RWD contexts. To be included, a manuscript should use statistical methods to address transportability and present practical, health-related examples of transportability. If the publications focused on methodological aspects without practical examples or aimed to test model validity, they were excluded.</p><p><strong>Results: </strong>The search identified 441 records and 13 were included for analysis. Of these, ten used Inverse Odds of Sampling Weights (IOSW), one used Inverse Probability Weighting (IPW), one used G-computation and another used standardization. Most studies applied transportability methods to transport RCT findings to real-world populations, two to transport between RWD sources for applications across disease areas or geographic locations. Common limitations reported included unmeasured confounding, differences in patient management and motivation, and challenges related to sample size.</p><p><strong>Conclusion: </strong>IOSW was the primary method used for transportability, predominantly within the same country when individual-level data from both the study population and target population could be combined. Our findings reveal that practical applications of transportability remain largely limited to national contexts, with few cross-country implementations observed.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 3","pages":"203388"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic and population-based analysis of surgical and embolization treatments for uterine fibroids in France (2011-2022): assessing utilization and access.","authors":"Fabien de Oliveira, Lucas Léger, Agathe Debeauvais, Chris Serrand, Jean-Paul Beregi, Audrey Lamouroux, Thierry Boudemaghe, Vincent Letouzey, Julien Frandon","doi":"10.1016/j.jeph.2026.203386","DOIUrl":"https://doi.org/10.1016/j.jeph.2026.203386","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine fibroids are the most common benign tumors in women and can be treated through various surgical and minimally invasive procedures. This study aimed to describe the utilization of surgical and embolization treatments for uterine fibroids in France. Secondary objectives were to analyze their geographic distribution and investigate potential associations between the different treatment techniques.</p><p><strong>Methods: </strong>This study used exhaustive data from the French national hospital discharge database (Programme de Médicalisation des Systèmes d'Information, PMSI) for the years 2011 to 2022. Women aged 15 to 99 years with a diagnosis of uterine fibroids and a hospital stay for myomectomy, hysterectomy, or uterine artery embolization were included. Patient characteristics and treatment facility locations were collected. Procedure rates were geographically estimated. Associations between treatment techniques were analyzed using linear regression.</p><p><strong>Results: </strong>Among 633,506 hospitalizations for uterine fibroids, 48.4% involved hysterectomy, 30.3% myomectomy, and 2.5% embolization. Patient age, length of hospital stay, and rehospitalization timing varied by treatment. Marked regional disparities were observed in procedure rates. A strong inverse association was identified between hysterectomy and the use of alternative treatments (R² = 0.77). In-hospital mortality was low across all groups.</p><p><strong>Conclusion: </strong>National hospital discharge data can be used to describe the distribution of uterine fibroid treatments in France. Hysterectomy remains the most frequently performed procedure, but significant regional disparities suggest unequal access to minimally invasive alternatives such as myomectomy and embolization.</p>","PeriodicalId":517428,"journal":{"name":"Journal of epidemiology and population health","volume":"74 3","pages":"203386"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}