[The eastern Paris perinatal network (2008-2010). Defining the target population and assessing health needs].
BACKGROUND
Since the 1990s, governmental plans in France have imposed the regionalization of perinatal care to improve both safety and quality of care. The Eastern Paris Perinatal Network is under construction in health area 75-2, which includes the 11th, 12th, 13th and 20th arrondissements of Paris. A major issue is ensuring that the network can meet the needs of its target population. The objective is to define the network's target population of mothers and newborns.


METHODS
We designed a matrix to help assess these needs and identify the data required to define the network's population. Four principal data sources were analyzed: the National Statistics and Economic Studies Institute (Insee) data, annual health facility activity data, national medical informatics program data, and 8th-day health certificates.


RESULTS
The network's target population varies according to the precise perinatal period and the planning stage. For the conception period, it includes the general population and specifically all women of childbearing age (15-49 years). The health area included 672,000 inhabitants in 2006, 29% of them are women of childbearing age. The proportion of people born outside France and who are of foreign nationality ranges, according to arrondissement, from 13.2 to 20.0%; the mean for the Paris metropolitan area is 14.7%. Approximately 16,500 women gave birth in 2007, at nine obstetric facility sites in the health area (five level I, three level II, and one type III); only 41.46% of them resided in the health area. Approximately 2500 women living in the health area gave birth at a facility outside the area. The population likely to be covered by the network is thus estimated at approximately 19,000 women.


CONCLUSIONS
A network must simultaneously take into account the local resident population and the population using its health care system. In an urban area such as Paris, where the health care supply is dense, it is essential for policy planning process to define the contours of the target population of a health network.
Serfaty
A
A
Département d'information médicale, groupe hospitalier Armand-Trousseau La Roche-Guyon, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France. annie.serfaty@trs.aphp.fr <annie.serfaty@trs.aphp.fr>
Gold
F
F
Benifla
J-L
JL
Breart
G
G
D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D008428:Maternal Mortality; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D020380:Needs Assessment / Q000458:organization & administration*; D009937:Organizational Objectives; D010297:Paris / Q000453:epidemiology; D018743:Perinatal Care / Q000458:organization & administration*; D011159:Population Surveillance; D012040:Regional Health Planning / Q000458:organization & administration*; D019037:Urban Health Services / Q000458:organization & administration*