ABSTRACT
Knowing the prevalence of potentially avoidable hospitalizations (PAHs) and the factors associated with them is essential if preventive action is to be taken. Studies on PAHs mainly concern adults, and very few have been carried out in South America. To the best of our knowledge, there has been no study on PAHs in French Guiana, particularly among older adults. This case-control study aimed to estimate the prevalence of PAHs in the Guianese population aged over 65 and to analyze their associated factors. We used the 2017-2019 data from the French National Health Service database (Système National des Données de Santé). The patients were age- and sex-matched 1 : 3 with controls without any PAH in 2019. Factors associated with PAHs were investigated through two conditional logistic regression models [one including the Charlson comorbidity index (CCI) and one including each comorbidity of the CCI], with calculation of the adjusted odds ratio (aOR) and 95% confidence interval (CI). The PAH incidence was 17.4 per 1000 inhabitants. PAHs represented 6.6% of all hospitalizations (45.6% related to congestive heart failure or hypertension). A higher CCI was associated with PAHs [aOR 2.2 (95% CI: 1.6, 3.0) and aOR 4.8 (95% CI: 2.4, 9.9) for 1-2 and ≥3 comorbidities, respectively, versus 0], as was immigrant health insurance status [aOR 2.3 (95% CI: 1.3, 4.2)]. Connective tissue disease, chronic pulmonary disease, congestive heart failure, diabetes, and peripheral vascular disease were comorbidities associated with an increased risk of PAHs. While the prevention of PAHs among immigrants is probably beyond the reach of the Guianese authorities, primary care and a public health policy geared toward prevention should be put in place for the French Guianese population suffering from cardiovascular disease in order to reduce PAHs.
Subject(s)
Hospitalization , Humans , French Guiana/epidemiology , Aged , Male , Female , Hospitalization/statistics & numerical data , Case-Control Studies , Aged, 80 and over , Comorbidity , Risk Factors , Databases, FactualABSTRACT
INTRODUCTION: With the increase in life expectancy of the population, the progression of chronic diseases, in particular cardiovascular diseases, neurodegenerative diseases (NDD) and their complications, health and medico-social care represents a major public health issue. OBJECTIVE: The aim of this article is to present an overview of the situation of the elderly and the current organization of the healthcare system for their care in French Guiana. METHOD: A review of the literature and analysis of the most recent data related to demographics, socioeconomics, morbidity and mortality, supply and use of care, were carried out. For comparative purposes, these data were compared with those for mainland France and the other French overseas departments and regions when available. RESULTS: With an average annual growth rate of +6.7% among people aged 65 and over, the highest in France (excluding Mayotte), the aging phenomenon has begun in French Guiana, although its population is still young. The health status of the elderly in French Guiana, characterized by an early onset of dependency and a greater prevalence of silent diseases (arterial hypertension, diabetes, hypercholesterolemia), is less favorable than in mainland France. In addition, the health and medico-social provision for the elderly remain incomplete or even embryonic, with little adapted support for elderly people with NND. CONCLUSION: This review highlights the situation of elderly people and the challenges for the health system.
Introduction: Avec l'allongement de l'espérance de vie de la population, la progression des maladies chroniques, notamment des maladies cardioneurovasculaires, maladies neurodégénératives (MND) et leurs complications, la prise en charge sanitaire et médico-sociale représente un enjeu majeur de santé publique. Objectif: Cet article a pour objectif de présenter un état des lieux de la situation des personnes âgées (PA) et de l'organisation actuelle du système de santé pour leur prise en charge en Guyane. Méthode: Une revue de la littérature et l'analyse de données démographiques, socioéconomiques, de morbidité et de mortalité, d'offre et de recours aux soins les plus récentes ont été réalisées. À des fins de comparaison, ces données ont été confrontées avec celles de la France hexagonale et des autres départements et régions d'outre-mer lorsque celles-ci étaient disponibles. Résultats: Avec un taux d'accroissement annuel moyen de +6,7 % chez les 65 ans et plus le plus élevé de France (hors Mayotte), le phénomène de vieillissement est amorcé en Guyane, bien que sa population reste encore jeune. L'état de santé des PA en Guyane, caractérisé par une entrée en dépendance précoce et une plus grande prévalence des maladies silencieuses (hypertension artérielle, diabète, hypercholestérolémie), est moins favorable qu'en France hexagonale. De plus, l'offre sanitaire et médico-sociale pour les PA reste lacunaire, voire embryonnaire, avec peu d'accompagnement adapté pour PA atteintes de MND. Conclusion: Cet état des lieux met en exergue la situation des PA et des enjeux pour le système de santé.