ABSTRACT
OBJECTIVES: To assess ambulatory surgery practices in France, make an inventory of projects for the creation of ambulatory structures and analyze the perception of different hospital personnel of ambulatory surgery. METHODS: A questionnaire was sent to 541 public hospitals with a surgery unit in France. The first part of the questionnaire was used to record current activity and existing projects for ambulatory surgery. The questionnaire also collected opinions concerning the analysis of difficulties encountered and possibilities offered by ambulatory surgery. RESULTS: Overall participation rate was 59%. Ambulatory surgery was practised in 81% of the hospitals. Sixty-six percent had a projects under consideration, including several at the decision making stage (17%). 1550 ambulatory surgery clinics could be created by the year 2000. In 66% of the cases, the future facility would be integrated into the traditional surgery unit. There was favorable opinion concerning the development of ambulatory surgery clinics in public hospitals in 83% of the cases. Inconveniences suggested generally involved organizational aspects, particularly concerning medical organization. Foreseen obstacles to the development of ambulatory surgery clinics were regulatory procedures, unfavorable exchange rate, insufficient investment funds and the lack of a policy favoring their development. CONCLUSION: The development of ambulatory surgery clinics in public hospitals in France can be expected in the near future. Budgeting and regulatory procedures must however be adapted to promote implementation of the existing projects.
Subject(s)
Attitude of Health Personnel , Hospitals, Public , Personnel, Hospital/psychology , Surgicenters/organization & administration , Decision Making, Organizational , Facility Regulation and Control , Forecasting , France , Health Services Research , Humans , Program Development , Program Evaluation , Surveys and QuestionnairesABSTRACT
The specificity of childhood cancers and the lack of available incidence data in Europe (with the exception of the Manchester and Turin registries) led to the creation of two French regional childhood cancer registries (CCR), in Nancy (1983) and Marseille (1984); both are population based CCR, respectively covering 535,236 and 809,196 children (0 to 14 years). All malignant neoplasms, brain tumours (whatever the grading) and borderline malignancies are included. Data have been collected from medical and administrative sources. Registration is active and each source is recontacted annually. The registries contact all physicians who might include children among their patients (private and hospital practice) and pathology-cytology laboratories. The University Hospital Centers and Anti-Cancer Centers in adjacent regions and in Paris are contacted. Data collected are the following: name, age, sex, address, time and method of diagnosis, histology, anatomical site, stage, treatment and sources of information. We combined our own data with those of a general cancer registry, set up in Strasbourg in 1975 and covering 205,889 children. The reliability of the methodology is attested by the similarity of results to those obtained in other European, US and Australian CCR. This type of registry is needed for organizing studies on the descriptive, analytical and experimental epidemiology in pediatric oncology.
Subject(s)
Neoplasms/epidemiology , Adolescent , Central Nervous System , Child , Child, Preschool , Female , France/epidemiology , Humans , Infant , Leukemia/epidemiology , Lymphoma/epidemiology , Male , Nervous System Neoplasms/epidemiology , RegistriesABSTRACT
Following the well-known European CCRs of Manchester and Turin, 2 regional CCRs have been recently created in France: in Nancy (1983) and Marseille (1984); both are population based CCRs, covering respectively 535,200 and 809,200 children (0-14 yrs). All malignant neoplasms are included, as well as brain tumours (whatever grading) and borderline malignancies. Data are collected from medical and administrative sources. Registration is active and every source is recontacted annually. The registries contact all physicians who might include children among their patients (private and hospital practice), and laboratories of pathology-cytology. The University Hospital Centers and Anti-Cancer Centers in adjacent regions, and in Paris are contacted. Death certificates for children dying of a malignant neoplasm are also sent to the registry. Data collected are as follows: name, age, sex, address, date and method of diagnosis, histological type, anatomical site, stage, treatment and sources of information. We added the data of a general cancer registry, created in Strasbourg in 1975 and covering 205,900 children. reliability of the methodology is attested by the similarity of the results obtained in other European, US and Australian CCRs. In conclusion, this type of registry is needed to organize multicentric epidemiological studies about the role of etiological factors, the survival, and the long term sequelae.
