title: [Health status of populations living in French overseas territories in 2012, compared with metropolitan France: An analysis of the national health insurance database].
abstract: BACKGROUND
  This study uses healthcare consumption to compare the health status of beneficiaries of the French national health insurance general scheme between individuals living in French overseas territories (FOT) and those living in metropolitan France.
  
  
  METHODS
  Data were extracted from the French national health insurance database (Sniiram) for 2012, using algorithms, 56 groups of diseases and 27 groups of hospital activity were isolated. Standardized morbidity ratio for age and sex (SMR) were used to compare FOT to mainland France.
  
  
  RESULTS
  Compared with mainland France, people living in the four FOT had high SMR for diabetes care (Guadeloupe 1.9; Martinique 1.7; Guyane 1.9; La Réunion 2.3), dialysis (2.7; 2.4; 3.8; 4.4), stroke (1.2; 1.1; 2.0; 1.5), and hospitalization for infectious diseases (1.9; 2.5; 2.4; 1.4) and obstetrics (1.4; 1.2; 1.9; 1.2). Care for inflammatory bowel disease or cancer were less frequent except for prostate in Martinique and Guadeloupe (2.3). People living in Martinique, Guadeloupe and la Reunion had more frequently care for psychotic disorders (2.0; 1.7; 1.2), dementia (1.1; 1.3; 11), epileptic seizures (1.4; 1.4; 16) and hospitalizations for burns (2.6; 1.7; 2.9). In la Reunion, people had more frequently coronary syndrome (1.3), cardiac heart failure (1.6), chronic respiratory diseases except cystic fibrosis (1.5), drug addiction (1.4) and hospitalizations for cardiovascular catheterization (1.4) and toxicology, poisoning, alcohol (1.7). Other differences were observed by gender: HIV infection, peripheral arterial disease, some chronic inflammatory disease (lupus) were more frequent in women living in Martinique or Guadeloupe, compared to women from mainland France and psychotic disorders for men. From la Reunion, men had more frequently liver and pancreatic diseases and hospitalisation for toxicology, poisoning, alcohol than men from mainland France.
  
  
  CONCLUSIONS
  This study highlights the utility of administrative database to compare and follow population health status considering healthcare use. Specific Public Health policies are justified for FOT, taking into account the specific context of each FOT, the necessity of prevention initiatives and screening to reduce the frequency of the chronic diseases.
authors.affiliation: Département des études sur les pathologies et les patients (DEPP), caisse nationale d'Assurance maladie des travailleurs salariés, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France.
authors.forename: A
authors.initials: A
authors.lastname: Filipovic-Pierucci
authors.affiliation: Département des études sur les pathologies et les patients (DEPP), caisse nationale d'Assurance maladie des travailleurs salariés, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France.
authors.forename: A
authors.initials: A
authors.lastname: Rigault
authors.affiliation: Département des études sur les pathologies et les patients (DEPP), caisse nationale d'Assurance maladie des travailleurs salariés, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France.
authors.forename: A
authors.initials: A
authors.lastname: Fagot-Campagna
authors.affiliation: Département des études sur les pathologies et les patients (DEPP), caisse nationale d'Assurance maladie des travailleurs salariés, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France. Electronic address: philippe.tuppin@cnamts.fr.
authors.forename: P
authors.initials: P
authors.lastname: Tuppin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D005616:French Guiana / Q000453:epidemiology; D019430:Guadeloupe / Q000453:epidemiology; D006304:Health Status; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity; D009313:National Health Programs / Q000706:statistics & numerical data; D017508:Reunion / Q000453:epidemiology; D055815:Young Adult
keywords: Assurés; Consommation de soins; Départements d’outre-mer; French overseas territories; Healthcare use; Hospital; Hôpital; Insured people; Morbidity; Morbidité