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Adequacy of care for patients with multiple disabilities in the French healthcare system: A study of 782 patients

Rousseau MC, Billette de Villemeur T, Khaldi-Cherif S, Brisse C, Felce A, Baumstarck K, Auquier P, French Polyhandicap Group.

PLoS One. 2018 6;13(7):e0199986. doi: 10.1371/journal.pone.0199986. eCollection 2018.

Mediation/Education :

This article looks at the question of whether the care system is appropriate to the age and severity of people with multiple disabilities. Two main types of care are offered in France, depending on the severity of the disability:

  • Facilities specializing in Medical and Rehabilitation Care (SMR): offering a high level of medical and paramedical care and prevention of complications
  • Medical-social establishments (MS): offering a high level of educational and psychosocial care

The aim of this article was to document the adequacy of care for 782 multi-disabled people accommodated in four SMR and nine MS facilities (2015-16). The adequacy of care was assessed on the basis of:

  • Two objective indicators: is the person in the right structure for his or her severity? severity their condition and age
  • Three subjective indicators: the referring physician’s assessment of i) the adequacy of medical care, ii) the adequacy of educational care and iii) the need for a change of structure.

The results of the study showed that the adequacy of care, according to the indicators studied, was more respected in SMR structures than in MS structures.

These preliminary results provide a substantial and innovative description of support for people with multiple disabilities in terms of the match between the person’s characteristics and the places where they are cared for.

Longitudinal and medico-economic studies could complement these results.