France: new government, new focus on medical deserts?

Pierron, J; Roca, Anne

doi:10.1016/s2468-2667(17)30138-x

Cited by 5 publications

(5 citation statements)

References 1 publication

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“…This situation generates an important burden of treatment for patients that can affect their lives as much—or more—than the diseases themselves 7 8. In addition, in France, the care for patients with chronic conditions is affected by the decreasing medical coverage of large parts of the French territory because of a cost containment-driven policy to limit the number of professionals trained in medical schools and the progressive closure of local care structures for the benefit of larger urban medical centres 9. As a result, health professionals are asked to do more in less time and patients are hurried along in their consultations 10–12.…”

Section: Introductionmentioning

confidence: 99%

Patients’ perspective on how to improve the care of people with chronic conditions in France: a citizen science study within the ComPaRe e-cohort

Tran

Riveros

Péan³

et al. 2019

BMJ Qual Saf

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BackgroundThis study aimed to involve patients with chronic conditions in generating ideas for improving their care.MethodsWe performed a citizen science study. Participants were adult patients with chronic conditions recruited in Community of Patients for Research ‘ComPaRe,’ a French e-cohort of patients with chronic conditions. Participants generated ideas to improve their care in answer to the open-ended question, ‘If you had a magic wand, what would you change in your healthcare?’ Three researchers and two patients independently extracted ideas from open-ended answers by using thematic analysis. Ideas were grouped into areas for improvement at the consultation, hospital/clinic and health system levels. Findings were validated and enriched by a second sample of participants recruited in ComPaRe.ResultsBetween May 2017 and April 2018, a total of 1636 patients provided 3613 ideas to improve consultations (1701 ideas related to 58 areas for improvement), hospitals/clinics (928 ideas related to 41 areas for improvement) and the health system (984 ideas related to 48 areas for improvement). At the consultation level, most ideas were related to improving physician–patient discussions, informing patients about their own care, and adapting treatment to patient preferences and context. At the hospital/clinic level, most ideas aimed at improving the coordination and collaboration in care. At the health system level, most ideas were related to decreasing the administrative burden imposed on patients, improving access to care and reducing the costs of care.ConclusionPatients have many ideas to improve their care, from the content of consultations to the organisation of hospitals. Our study provides the proof of concept for a method to leverage patients’ practical knowledge of the care system to improve it.

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Section: Introductionmentioning

confidence: 99%

Patients’ perspective on how to improve the care of people with chronic conditions in France: a citizen science study within the ComPaRe e-cohort

Tran

Riveros

Péan³

et al. 2019

BMJ Qual Saf

View full text Add to dashboard Cite

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“…Lower density places face different concerns. Dispersed populations and longer distances to services reduce access and can increase inequalities, leading to such phenomena as 'medical deserts' (Pierron and Roca, 2017;Sanz-Barbero et al, 2012). The cost of public service provision generally increases with the degree of remoteness and sparsity due to transportation costs/distance, loss of economies of scope and scale, and greater difficulty in attracting and retaining professionals (e.g., health care professionals).…”

Section: Governance At the Right Scalementioning

confidence: 99%

Can Governance at the Right Scale Increase Productivity? A Comparative Scoping Review

Krawchenko

2022

Canadian Journal of Regional Science

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Enhancing productivity is a common rationale for devolution, outsourcing and new institutional configurations and a recurring theme in public administration reforms. Functions such as urban planning, infrastructure development, water management, and transportation planning have clear spatial characteristics wherein their governance ideally spans their functional use and/or management. These considerations have led to municipal amalgamations and two-tier governance in an eff ort to consolidate functions and build economies of scale and to the creation of special purpose, intermediate or regional bodies to manage public investments and deliver specialised services. While there is a growing urban literature on governance at the right scale in certain policy areas, far fewer studies explore these factors in lower density places (towns and rural and remote areas). Moreover, how eff ective and eff icient governance might boost productivity both within the institution and more generally, across the local/regional economy is underexplored. This paper takes stock of how governance at the right scale might improve public sector productivity in diff erent types of places-urban, rural and remote. It draws on theoretical, empirical and policy literature to explore how scale matters to public sector productivity and governance.

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“…13 In the early days, especially in Canada, agreements focused on a combination of employment and environmental protections, while today they encompass a wide range of activities-from education and training, to funds for economic development, socio-cultural support and communications structures, environmental monitoring and protection, direct payments and finance or commercial terms (see Table A A.1.). In Australia these agreements are referred to as Indigenous Land Use Agreements (ILUA) in the case of Native Title Land, 14 in Canada they are called Impact and Benefit Agreements (IBAs), in New Zealand the terminology differs by agreement type, 15 and in the United States there is a mix of terminology related to specific legislation. 16 Here the term benefit sharing agreement will be used.…”

Section: Entering and Managing Benefit Sharing Agreements From A Place Of Strengthmentioning

confidence: 99%

“…The benefit sharing agreement mechanism is different under the NT Aboriginal Land Rights Act. Not all Native Title agreements are ILUAs 15. In New Zealand there are three general types of agreements: resource agreements, confidentiality agreements and relationships agreements (Te Runanga o Ngāti Ruanui Trust, 2014).…”

mentioning

confidence: 99%

Leading practices for resource benefit sharing and development for and with Indigenous communities

Raderschall¹,

Krawchenko²,

Leblanc³

2020

OECD Regional Development Papers

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This OECD working paper summarises leading practices for benefit sharing, workforce development, and business and governance development for and with Indigenous peoples. This work has been informed by the OECD's programme of work on Linking Indigenous Communities with Regional Development, on Mining Regions and Cities and on Indigenous Employment and Skills Strategies. This working paper specifically aims to inform the Department of Infrastructure, Transport, Cities and Regional Development of Australia. The paper covers six key policy areas: i) Indigenous benefits funds and benefit sharing agreements, ii) Indigenous governance, iii) Indigenous entrepreneurship, iv) Indigenous education and training, v) Indigenous employment, and vi) Indigenous community programmes.

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France: new government, new focus on medical deserts?

Cited by 5 publications

References 1 publication

Patients’ perspective on how to improve the care of people with chronic conditions in France: a citizen science study within the ComPaRe e-cohort

Patients’ perspective on how to improve the care of people with chronic conditions in France: a citizen science study within the ComPaRe e-cohort

Can Governance at the Right Scale Increase Productivity? A Comparative Scoping Review

Leading practices for resource benefit sharing and development for and with Indigenous communities

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