title: [Socio-demographic characteristics and health status of patients at a free-of-charge outpatient clinic in Paris].
abstract: OBJECTIVE
  In the context of the French National Health Service, a free access to healthcare facilities (the PASS: "permanence d'accès aux soins de santé") has been implanted in 2000 for patients without health insurance or those dealing with financial hardship. There is few data about socio-demographic characteristics of the patients using these services. The objective of this study was to provide descriptive data about socio-demographic characteristics and motivation of those patients who use these clinics.
  
  
  METHODS
  This descriptive cross-sectional study was conducted between April an May 2008, in 5 PASS clinics from academic tertiary hospitals in Paris. Descriptive data on patient were collected by general practitioners at the end of their consultations.
  
  
  RESULTS
  This study included 581 patients. The mean age was 42 years, and 65% of patients were males. Only 50.9% declared a salary income and 38.5% had a health insurance. Half of the patients were homeless, and 80% were migrants. The main reasons to visit these health facilities were direct access (no appointment needed), being in financial difficulty and having a medical record in the same hospital. Half of the patients had one chronic disease at least, while only a third of them saw regularly a physician. A total of 834 diseases were found among the 581 patients, including 411 chronic diseases, and 17% of the patients had a psychologic or a psychiatric disorder. Prognosis was divided in three grades: good, low and poor. Almost a half of the patients were considered by the doctor as having a low or a poor prognosis if they would not receive a therapy.
  
  
  CONCLUSIONS
  The findings of this study suggest that the PASS carry out their mission: most of the patients frequenting these facilities live under poor conditions and are in poor health status compared to the patients having access to conventional outpatient services.
authors.affiliation: PASS, unité de médecine générale sans rendez-vous, policlinique Beaudelaire, hôpital Saint-Antoine, AP-HP, 75012 Paris, France. Electronic address: kaouaba@yahoo.fr.
authors.forename: B
authors.initials: B
authors.lastname: Kaoutar
authors.affiliation: PASS, consultation Verlaine, hôpital Saint-Louis, 75010 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Gatin
authors.affiliation: PASS, centre de diagnostic et thérapeutique, hôpital Hôtel-Dieu, AP-HP, 75004 Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: de Champs-Leger
authors.affiliation: PASS, unité de médecine générale sans rendez-vous, policlinique Beaudelaire, hôpital Saint-Antoine, AP-HP, 75012 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Vasseur
authors.affiliation: PASS, hôpital de Lariboisière, AP-HP, 75018 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Aparicio
authors.affiliation: PASS, consultation de médecine, département de médecine interne et immunologie clinique, hôpital La Pitié, AP-HP, 75013 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: de Gennes
authors.affiliation: PASS, unité de médecine générale sans rendez-vous, policlinique Beaudelaire, hôpital Saint-Antoine, AP-HP, 75012 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Lebas
authors.affiliation: Inserm, UMR S 707, équipe de recherche sur les déterminants sociaux de la santé et du recours aux soins, université Pierre-et-Marie-Curie, Paris-6, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Chauvin
authors.affiliation: PASS, consultation Verlaine, hôpital Saint-Louis, 75010 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Georges
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D010044:Outpatient Clinics, Hospital; D010297:Paris; D014171:Transients and Migrants / Q000706:statistics & numerical data; D017664:Uncompensated Care
keywords: Chronic disease; Free access to health care service; Maladie chronique; Morbidity; Morbidité; Outpatient clinic; Parcours de soins; Permanence d’accès aux soins de santé; Précarité; Vulnerability