%0 Journal Article
%T Sirolimus-eluting coronary stents: evaluation of practices in healthcare establishments
%A Albizzati J
%A Ronfle E
%A Morel G
%A Mabriez JC
%J Revue M¨¦dicale de l'Assurance Maladie
%D 2005
%I 
%X Aim : To compare professional practices for implantation of sirolimus-eluting coronary stents with medico-administrative cover criteria in healthcare establishments in the Provence Alpes C te d'Azur (PACA) region. Method : Retrospective descriptive study of coronary angioplasty procedures using sirolimus-eluting stents implanted between September 24, 2003 and December 31, 2003 in establishments in the PACA region. Results : The study concerned 895 sirolimus-eluting stents implanted and invoiced in 12 establishments subject to the "objectif quantifi¨¦ national" (OQN) financing system (system of national quantified targets for private hospitals) and 163 implanted in eight establishments subject to the "dotation globale" (DG) financing system (global budget system for public hospitals). Deviations relative to the medico-administrative conditions for cover were observed for 31 % of the sirolimus-eluting stents implanted in OQN establishments (usually concerning the number of stents per angioplasty and the length of the lesions) and for 39 % of those implanted outside the study protocol in DG establishments (mainly concerning non de novo lesions and the length of lesions). Conclusion : Practitioners do not comply with the regulatory reference system in practice, arguing that there is a discrepancy between the therapeutic indications necessary for patients and the criteria for cover in the list of roducts and services. Since the study, modifications have led to clarification and updating of this reference system, compliance with which is essential for medico-economic reasons.
%K stent
%K sirolimus
%K angioplasty
%K medical audit
%U http://www.ameli.fr/fileadmin/user_upload/documents/Endoprotheses_coronaires.pdf