[Medical, psychological and social study in 350 patients in a precarious situation, undertaken by a permanently maintained health care facility in 2002].
OBJECTIVE
Precariousness and its consequences have not been re-evaluated in France since the introduction of the Law to fight exclusion, which instituted Universal Medical Cover (CMU) and permanently maintained health care facilities (PASS) in 1998.


METHODS
Throughout the year 2002, a descriptive medical, psychological and social prospective study was carried out amongst PASS patients seen in 2002 at Avignon Hospital.


RESULTS
Three hundred and fifty out of 359 patients have been analysed. Most of them were adults (93%), young (mean age 38), male (56%), foreigners from non-EU countries (73%), with an illegal status (69%). They were without any declared income (77%), but with accommodation (67%), living as married (or such) or single in equal proportion. They were often without social security cover (48%). Their dominant pathologies were infections (42% of the patients). The most frequently diagnosed conditions were obesity (14%), pregnancy (8%), lower back pain (7%), high blood pressure (7%), chronic hepatitis C virus infection (6%), fungal infections (6%) and traumas (6%). Dental (43%) and psychiatric (27%) disorders were very frequent. The analysis of sub-groups has shown that some disorders are more frequent in French and European patients: chronic hepatitis C virus infection (14% vs. 4%), traumas (14% vs. 4%), psychopathy (11% vs. 0%), alcohol abuse (32% vs. 5%), smoking (80% vs. 25%), cannabis (20% vs. 2%) or opioids (16% vs. 0%) use.


CONCLUSIONS
Access to health care has been difficult in 2002 in Avignon mostly for illegal immigrants for whom the only valid response should be of a political nature. Both French and European communities who still do not benefit from CMU improvements probably mean local interventions and combined operations because of the homelessness and the addictions of these people.
de la Blanchardière
A
A
Permanence d'accès aux soins de santé, pôle santé publique, hôpital H.-Duffaut, 305, rue R.-Follereau, 84902 Avignon cedex, France. adelablanchardiere@ch-avignon.fr
Méouchy
G
G
Brunel
P
P
Olivier
P
P
D000208:Acute Disease; D000328:Adult; D003695:Delivery of Health Care; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006297:Health Services Accessibility; D006801:Humans; D007239:Infections / Q000628:therapy; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D011446:Prospective Studies; D012943:Social Security; D012944:Social Support; D019966:Substance-Related Disorders / Q000628:therapy; D014171:Transients and Migrants; D014947:Wounds and Injuries