Human Body Systems Relationships

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FRANCE

CHAPTER 8

KEY CONCEPTS

  • Amenable Mortality
  • ANAES
  • Docteur
  • SAMU

INTRODUCTION AND HISTORICAL OVERVIEW

  • Developed (industrialized) country
  • Leader among European countries
  • World power
  • Highly ranked health care system
  • Strong economy
  • More than years and older

INTRODUCTION AND HISTORICAL OVERVIEW

  • Residents, majority native born
  • Many immigrants, strong African and Southeast Asian presence
  • Population demographics (WHO, 2004)
  • Under 15 year old age group, 18%
  • Over 60 year old age group, 20%
  • 16% of population 65
  • Predominate language, French

INTRODUCTION AND HISTORICAL OVERVIEW

  • Overall life expectancy 78.9 years
  • (83.01 women; 75.01 men)
  • Estimated infant and neonatal mortality rate, 4.46 deaths/1,000 live births
  • Literacy rate, 99% overall
  • Universal health care system (Well funded)

INTRODUCTION AND HISTORICAL OVERVIEW

  • National Health Care since 1945
  • Threefold goal:
  • Single health insurer
  • Compulsory for all employers and workers, premium-based
  • Allow patients to choose their doctors
  • No lengthy wait periods for elective surgery or specialists

STRUCTURE

  • Ministry of Health
  • Low Fees for Services
  • Government Funded Medical School with Service Stipulations
  • Modest Physicians Salaries, Average €40,000 ($51,243) (Tanner, 2008)
  • Assurance Maladie (AM), The Country’s Largest Buyer of Medical Services

STRUCTURE

  • Approximately 90% of France’s general practitioners contract with Assurance Maladie
  • Practicing nurses 6.7 per 1,000 (OECD, 2008)
  • Practicing physicians 3.37 per 1,000 (OECD, 2008)

FINANCING

  • Health care spending - 11% of GDP
  • 96% Population Covered
  • Social Security Fund
  • Protection Maternelle et Infantile
  • Goal- Decrease Costs, while Preserving NHS
  • Hospital Beds
  • 65% Public
  • 15% Private

INTERVENTIONAL

  • Emphasis on health and wellness
  • RN Education – 3 years, advocacy for increased entry level to practice
  • ANAES-Standardized practice guidelines to improve services
  • Collaborative agreements with Canada to improve nursing outcomes

PREVENTIVE

  • Amenable Mortality
  • Protection Maternelle et Infantile
  • Epidemiological surveying
  • Excellent track record with prenatal, child, and older adult care

PREVENTIVE

  • Amenable Mortality – Deaths that could have been prevented with good health
  • Protection Maternelle et Infantile – Improving prenatal outcomes by promoting health of mom and child
  • Epidemiological surveying – predicting and containing disease outbreaks

RESOURCES

  • Protection Maternelle et Infantile – Significantly increases basic preventive care for mother and children
  • Palliative care
  • End-of-life care

Top Ten Causes of Death

Ischemic heart disease

Cerebrovascular Disease (Stroke)

Trachea, bronchus and lung cancer

Lower respiratory infection

Colorectal cancer

Alzheimer’s disease

Chronic Obstructive Pulmonary Disease (COPD)

Breast cancer

Diabetes Mellitus

Falls

% Years of Life Lost to Disease

  • Ischemic heart disease, trachea, bronchus and lung cancer – 07%
  • Cerebrovascular Accident (CVA/stroke) – 05%
  • Breast cancer – 04%
  • Colorectal cancer – 03%
  • Diabetes mellitus, COPD, Lower respiratory infection – 02 %
  • Alzheimer’s disease and Falls – 01%

HEALTH DISPARITIES

  • Care in a variety of settings
  • Abundance of emergency services
  • Acute care in public, non-profit and for-profit with high workloads
  • Longer wait periods in public settings
  • Pay/salary inequities especially physicians