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. 2017 Dec 4;17(1):386.
doi: 10.1186/s12888-017-1555-0.

Use of medical administrative data for the surveillance of psychotic disorders in France

Christine Chan Chee  1 , Francis Chin  2 , Catherine Ha  2 , Nathalie Beltzer  2 , Christophe Bonaldi  2
Affiliations

Use of medical administrative data for the surveillance of psychotic disorders in France

Christine Chan Chee et al. BMC Psychiatry. .

Abstract

Background: Psychotic disorders are among the most severe psychiatric disorders that have great effects on the individuals and the society. For surveillance of chronic low prevalence conditions such as psychotic disorders, medical administrative databases can be useful due to their large coverage of the population, their continuous availability and low costs with possibility of linkage between different databases. The aims of this study are to identify the population with psychotic disorders by different algorithms based on the French medical administrative data and examine the prevalence and characteristics of this population in 2014.

Methods: The health insurance system covers the entire population living in France and all reimbursements of ambulatory care in private practice are included in a national health insurance claim database, which can be linked with the national hospital discharge databases. Three algorithms were used to select most appropriately persons with psychotic disorders through data from hospital discharge databases, reimbursements for psychotropic medication and full insurance coverage for chronic and costly conditions.

Results: In France in 2014, estimates of the number of individuals with psychotic disorders were 469,587 (54.6% males) including 237,808 with schizophrenia (63.6% males). Of those, 77.0% with psychotic disorders and 70.8% with schizophrenia received exclusively ambulatory care. Prevalence rates of psychotic disorders were 7.4 per 1000 inhabitants (8.3 in males and 6.4 in females) and 3.8 per 1000 inhabitants (4.9 in males and 2.6 in females) for schizophrenia. Prevalence of psychotic disorders reached a maximum of 14 per 1000 in males between 35 and 49 years old then decreased with age while in females, the highest rate of 10 per 1000 was reached at age 50 without decrease with advancing age. No such plateau was observed in schizophrenia.

Discussion: This study is the first in France using an exhaustive sample of medical administrative data to derive prevalence rates for psychotic disorders. Although only individuals in contact with healthcare services were included, the rates were congruent with reported estimates from systematic reviews. The feasibility of this study will allow the implementation of a national surveillance of psychotic disorders essential for healthcare management and policy planning.

Keywords: France; Medical administrative databases; Methodology; Prevalence; Psychotic disorders.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Because of the retrospective nature of this study, formal consent was not required.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Prevalence rates of psychotic disorders and schizophrenia by age and sex in France, 2014
Fig. 2
Fig. 2
Prevalence rates of psychotic disorders and schizophrenia by region in France, 2014
See this image and copyright information in PMC

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