[Health care consumption. Empirical evidence from a survey in a regional university hospital].
OBJECTIVE
Emergency departments of French hospitals have been coping with increasing activity for ten Years. This study is aimed at describing patterns of health care consumption for people admitted to emergency departments and at linking them to their declared socio-economic status.


METHODS
In May 2001, a survey was conducted in the emergency department of the Saint Roch Hospital in Nice, identifying the nature and motives of the persons admitted, health care consumption over the last Year and a set of socio-economic characteristics of the patients.


RESULTS
A persisting gap in health care consumption still remains to the detriment of poor people. There also seems to be a threshold effect for patients whose income only slightly exceeds the upper limit of revenues entitling them to universal health insurance or other social redistribution mechanisms. For this category of the population, health care consumption is significantly less than that of the rest of the population, although visits to the emergency department are more often unjustified.


CONCLUSIONS
Emergency departments are the major access to health care for people excluded from, or on the borderline of the health system. The extension of health insurance to populations excluded up till now, appears to induce underprivileged health traps, but at the same time making up for lost time (only partially in this study). Such effects merit consideration in order to ensure a continuum in the management of health requirements in low income populations.
Paraponaris
Alain
A
Faculté de sciences économiques et de gestion, Université de la Méditerranée, Marseille (13). paraponaris@marseille.ins.erm.fr
Obadia
Yolande
Y
Ben Diane
Marc-Karim
MK
Bertrand
François
F
Moatti
Jean-Paul
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003625:Data Collection; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007182:Income; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011203:Poverty; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires