Health check-ups for the French under-consuming agricultural population: A pilot evaluation of the Instants santé MSA program.
Health promotion
Healthcare disparities
Program evaluation
Promotion de la santé
Rural health
disparités d'accès aux soins
santé en zone rurale
évaluation de programme
Journal
Revue d'epidemiologie et de sante publique
ISSN: 0398-7620
Titre abrégé: Rev Epidemiol Sante Publique
Pays: France
ID NLM: 7608039
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
20
04
2021
revised:
17
11
2022
accepted:
05
12
2022
pubmed:
8
1
2023
medline:
22
2
2023
entrez:
7
1
2023
Statut:
ppublish
Résumé
The social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective was to carry out a pilot evaluation of this program. The evaluation was carried out on the population invited during the second semester of 2017 using data from the program's service providers (date of invitation, of nurse appointment…), regional MSA bodies (consultation voucher), and reimbursement data (other care consumption). Participation rates were calculated overall and by participant characteristics. Medical needs were identified during the nurse appointment and new care pathways were assessed using reimbursement data. Multivariable regression models identified factors associated with participation. 2366 beneficiaries were included in the analysis. 1559 (65.89%) were men and mean age was 52.41 (standard deviation = 14.86). 409 (17.29%) attended the nurse appointment. There was a significant increase in participation with age, in farmers vs. employees (odds ratio = 1.905, 95% confidence interval = 1.393-2.604), and in people living in the most disadvantaged areas (odds ratio = 1.579, 95% confidence interval=1.079-2.312). Participation to the consultation following the nurse appointment was high (62.35%-73.11%). 87.53% of participants had at least one medical need, and new care pathways were more frequent among those who had attended the nurse appointment (55.50% vs. 34.80%, p < 0.0001). This pilot evaluation shows promising results which need to be confirmed with a national evaluation of the program and longer-term evidence.
Sections du résumé
BACKGROUND
BACKGROUND
The social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective was to carry out a pilot evaluation of this program.
METHODS
METHODS
The evaluation was carried out on the population invited during the second semester of 2017 using data from the program's service providers (date of invitation, of nurse appointment…), regional MSA bodies (consultation voucher), and reimbursement data (other care consumption). Participation rates were calculated overall and by participant characteristics. Medical needs were identified during the nurse appointment and new care pathways were assessed using reimbursement data. Multivariable regression models identified factors associated with participation.
RESULTS
RESULTS
2366 beneficiaries were included in the analysis. 1559 (65.89%) were men and mean age was 52.41 (standard deviation = 14.86). 409 (17.29%) attended the nurse appointment. There was a significant increase in participation with age, in farmers vs. employees (odds ratio = 1.905, 95% confidence interval = 1.393-2.604), and in people living in the most disadvantaged areas (odds ratio = 1.579, 95% confidence interval=1.079-2.312). Participation to the consultation following the nurse appointment was high (62.35%-73.11%). 87.53% of participants had at least one medical need, and new care pathways were more frequent among those who had attended the nurse appointment (55.50% vs. 34.80%, p < 0.0001).
CONCLUSIONS
CONCLUSIONS
This pilot evaluation shows promising results which need to be confirmed with a national evaluation of the program and longer-term evidence.
Identifiants
pubmed: 36610246
pii: S0398-7620(22)00891-4
doi: 10.1016/j.respe.2022.101420
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101420Informations de copyright
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement MM, CD and KC report no conflict of interest apart from the funding received to carry out the study. MAS and VD are both employees of the funder, the Mutualité Sociale Agricole central body (CCMSA, Caisse centrale de la Mutualité Sociale Agricole).