The supply of therapeutic education for adults diabetic patients in the region of le-de-France: a challenge for equity

Summary Aim: The therapeutic education of a patient (TEP) aims to provide knowledge and competencies to the patient which enable him to control his sickness and to improve his standard of life. The aim of this survey was to establish a supply-inventory of the TEP programs for adult diabetic patients, with the exception of pregnant diabetic patients, of the le-de-France region hospitals as well as in ambulatory medicine with the objective of adapting itself with the supply and to assess the equity. Methods: Following a census of structures that had obtained funding for the TEP programs in 2008, the data had been collected on the basis of a closed questionnaire conducted through telephonic interviews. The data was related to the structure of the programs, the academic training of the participants, the pluri-disciplinary characteristic of the TEP, the relations with the doctor, the kind of sessions, the number of patients followed in 2008 and the obstacles as well as the engines for the development of the TEP. Results: The TEP supply comprises 67 structures out of which 46 medical institutes (68.7%), seven networks, three health centres, six health analysis centres, one insurance agency and three co-operative associations. Regarding the collective sessions, 84.9% were conducted in medical institutes out of which 37.1% in the various departments of Medical Colleges. All included, 9.2% of the diabetic patients of le-de-France had benefitted from the TEP in 2008, out of which 6.5% had benefited from collective sessions. The supply seemed inequitable. Conclusion: The TEP supply was essentially in hospitals. In order to develop a balanced supply, with the aid of a regional management, it seemed necessary to select the patients that must benefit preferentially from the TEP programs, to train general medical practitioners and to redeploy in part the offer towards the ambulatory sector. Prat Organ Soins. 2012;43(1):1-7