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Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs

OBJECTIVE: In France, immigrants with chronic diseases encounter numerous difficulties in gaining access to care and then in its initiation and organisation, difficulties only partly explained by socioeconomic factors. A transcultural mediation consultation programme has been set up in Necker Hospit...

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Autores principales: Lachal, Jonathan, Escaich, Mélanie, Bouznah, Serge, Rousselle, Clémence, De Lonlay, Pascale, Canoui, Pierre, Moro, Marie-Rose, Durand-Zaleski, Isabelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887050/
https://www.ncbi.nlm.nih.gov/pubmed/31753892
http://dx.doi.org/10.1136/bmjopen-2019-032498
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author Lachal, Jonathan
Escaich, Mélanie
Bouznah, Serge
Rousselle, Clémence
De Lonlay, Pascale
Canoui, Pierre
Moro, Marie-Rose
Durand-Zaleski, Isabelle
author_facet Lachal, Jonathan
Escaich, Mélanie
Bouznah, Serge
Rousselle, Clémence
De Lonlay, Pascale
Canoui, Pierre
Moro, Marie-Rose
Durand-Zaleski, Isabelle
author_sort Lachal, Jonathan
collection PubMed
description OBJECTIVE: In France, immigrants with chronic diseases encounter numerous difficulties in gaining access to care and then in its initiation and organisation, difficulties only partly explained by socioeconomic factors. A transcultural mediation consultation programme has been set up in Necker Hospital in Paris to help families and professionals deal with these situations. The objective of this study was to assess the economic impact and the experience of this consultation. DESIGN: Qualitative and quantitative descriptive study. SETTING: This study of inpatients treated at Necker Hospital included those whose families participated in transcultural mediation in 2014 through 2016. PARTICIPANTS: The first portion of the study applied quantitative methods and compared hospital costs before and after the mediation from the patients' records and accounting data for 15 cases. The qualitative portion analysed 15 semistructured interviews of physicians and families after the mediation, and a focus group of three psychologists. RESULTS: The results show a systematic reduction in costs after mediation, associated with fewer emergency hospitalisations and the shift of care toward less specialised facilities, calmer relationships between families and professionals, improved mutual understanding and increased confidence by the professionals in the families' ability to manage the treatment. CONCLUSION: Transcultural mediation can benefit both patients and the healthcare system and may be useful for other hospitals that care for socially and culturally diverse patients.
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spelling pubmed-68870502019-12-04 Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs Lachal, Jonathan Escaich, Mélanie Bouznah, Serge Rousselle, Clémence De Lonlay, Pascale Canoui, Pierre Moro, Marie-Rose Durand-Zaleski, Isabelle BMJ Open Mental Health OBJECTIVE: In France, immigrants with chronic diseases encounter numerous difficulties in gaining access to care and then in its initiation and organisation, difficulties only partly explained by socioeconomic factors. A transcultural mediation consultation programme has been set up in Necker Hospital in Paris to help families and professionals deal with these situations. The objective of this study was to assess the economic impact and the experience of this consultation. DESIGN: Qualitative and quantitative descriptive study. SETTING: This study of inpatients treated at Necker Hospital included those whose families participated in transcultural mediation in 2014 through 2016. PARTICIPANTS: The first portion of the study applied quantitative methods and compared hospital costs before and after the mediation from the patients' records and accounting data for 15 cases. The qualitative portion analysed 15 semistructured interviews of physicians and families after the mediation, and a focus group of three psychologists. RESULTS: The results show a systematic reduction in costs after mediation, associated with fewer emergency hospitalisations and the shift of care toward less specialised facilities, calmer relationships between families and professionals, improved mutual understanding and increased confidence by the professionals in the families' ability to manage the treatment. CONCLUSION: Transcultural mediation can benefit both patients and the healthcare system and may be useful for other hospitals that care for socially and culturally diverse patients. BMJ Publishing Group 2019-11-21 /pmc/articles/PMC6887050/ /pubmed/31753892 http://dx.doi.org/10.1136/bmjopen-2019-032498 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Mental Health
Lachal, Jonathan
Escaich, Mélanie
Bouznah, Serge
Rousselle, Clémence
De Lonlay, Pascale
Canoui, Pierre
Moro, Marie-Rose
Durand-Zaleski, Isabelle
Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs
title Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs
title_full Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs
title_fullStr Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs
title_full_unstemmed Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs
title_short Transcultural mediation programme in a paediatric hospital in France: qualitative and quantitative study of participants’ experience and impact on hospital costs
title_sort transcultural mediation programme in a paediatric hospital in france: qualitative and quantitative study of participants’ experience and impact on hospital costs
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887050/
https://www.ncbi.nlm.nih.gov/pubmed/31753892
http://dx.doi.org/10.1136/bmjopen-2019-032498
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