Morgane Michel

Assistance Publique – Hôpitaux de Paris | AP-HP

Human Papillomavirus (HPV) vaccine coverage was <50% in France in 2022 and even lower among socially disadvantaged populations. We aimed to evaluate socio-demographic determinants of HPV vaccine awareness, uptake, and intention among parents of adolescents, and related attitudes and knowledge items. Parents of adolescents attending middle schools a...

With the aim to optimize communication during HPV vaccination campaigns in France, we elicited parental preferences around HPV vaccination. We conducted a single-profile discrete choice experiment (DCE) among parents of 11- to 14-year-old middle-school pupils, who completed an anonymous, self-administered, internet-based questionnaire during 2020–2...

Importance The human papillomavirus (HPV) vaccine is safe and effective, yet vaccination coverage remains below public health objectives in many countries. Objective To examine the effectiveness of a 3-component intervention on HPV vaccination coverage among adolescents aged 11 to 14 years 2 months after the intervention ended, each component bein...

Background and Aims The length of stay (LOS) after transcatheter aortic valve implantation (TAVI) remains extremely variable whereas early discharge has been shown to be feasible and safe. The study objective was to evaluate the efficacy and safety of an intervention aimed at reducing LOS after transfemoral TAVI. Methods FAST-TAVI II is a prospect...

This review of the French health system analyses recent developments in health organisation and governance, financing, healthcare provision, recent reforms and health system performance. Overall health status continues to improve in France, although geographic and socioeconomic inequalities in life expectancy persist. The health system combines a s...

Background: Human papillomaviruses (HPV) are responsible for the most common sexually transmitted infection in the world and persistent infection of oncogenic types is associated with an increased risk of cancers. This infection could be prevented by vaccination. However, in a time of vaccine hesitancy, the decision to get vaccinated or to have a c...

Background In France, human papillomavirus (HPV) vaccination coverage varies across socioeconomic levels. Aim We aimed at assessing HPV vaccine awareness, uptake and vaccination intention among adolescents in France. Methods In a cluster-randomised study, 13–15-year-old students in 61 French middle schools completed a web-based questionnaire. We...

This review of the French health system analyses recent developments in health organisation and governance, financing, healthcare provision, recent reforms and health system performance. Overall health status continues to improve in France, although geographic and socioeconomic inequalities in life expectancy persist. The health system combines a s...

Introduction Despite various efforts to improve human papillomavirus (HPV) vaccine coverage in France, it has always been lower than in most other high‐income countries. The health authorities launched in 2018 the national PrevHPV research programme to (1) co‐develop with stakeholders and (2) evaluate the impact of a multicomponent complex interven...

With over one million deaths per year in the world, suicide is a major public health problem that could be significantly reduced by effective prevention programs. E-health tools are of particular interest for primary prevention as they can address a broad population including people unaware of their own risk and provide information and help without...

Background: It has been proven that vaccination is effective against Human Papillomavirus (HPV) infections, genital warts, and pre-cancerous and cancerous cervical lesions. Nevertheless, the HPV vaccine coverage of 37.4 % in 2021 in France is one of the lowest in Europe. To explore and understand the reason why French population is so late compare...

BACKGROUND Human papillomaviruses (HPV) are responsible for the most common sexually transmitted infection in the world and persistent infection of oncogenic types is associated with an increased risk of cancers. This infection could be prevented by vaccination. However, in a time of vaccine hesitancy, the decision to get vaccinated or to have a ch...

Objective: To assess the association between deprivation and the incidence and clinical severity of TB in children. Study design: Children ≤ 18 years old who were admitted for TB between 2007 and 2020 at a tertiary hospital were included in this retrospective study. Deprivation was assessed using the French Deprivation Index (FDep). TB severity...

Background: The social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective...

BACKGROUND With more than a million deaths per year and nearly one out of two people with suicidal thoughts not receiving any form of care in high-income countries, suicide is a major public health problem and a cause of avoidable mortality which could be significantly reduced by effective prevention programs. E-health tools present the advantage o...

Aims Over the last decade, transcatheter aortic valve replacement (TAVR) became extensively used, now being the recommended as first line procedure for aortic valve replacement (AVR) in selected patients' populations. It is unknown whether TAVR adoption rate and variability in outcomes is influenced by centers' volume. Methods From a French admini...

Despite proven efficacy against cervical cancer, the HPV vaccination coverage in France – since 2019 recommended to 11- to 14-year-old girls and boys – is low with 32.7 % of 16-year-old girls fully vaccinated (2020). Based on an integrative model to understand vaccination behaviour, we aimed at understanding which psychological antecedents explain...

Importance: Acute chest syndrome (ACS) is one of the leading acute severe complications of sickle-cell disease (SCD). Although Streptococcus pneumoniae (S pneumoniae) is highly prevalent in children with SCD, its precise role in ACS is unclear. The efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) implementation on ACS is still unknown....

Introduction: Vaccination is an effective and safe strategy to prevent Human papillomavirus (HPV) infection and related harms. Despite various efforts by French authorities to improve HPV vaccine coverage (VC) these past few years, VC has remained far lower than in most other high-income countries. To improve it, we have coconstructed with stakeho...

Aims Transcatheter aortic valve replacement (TAVR) as an alternative to surgical aortic valve replacement (SAVR) has profoundly changed the management of patients with aortic valve stenosis (AS). Large unbiased nationwide data regarding TAVR implementation, impact on SAVR and their respective outcomes are scarce. Methods and results Based on a Fre...

Objective To look at the association of socioeconomic status (SES) with the suitability of the maternity where children are born and its association with mortality. Design Retrospective analysis of a prospective cohort constituted using hospital discharge databases. Setting France Population Live births in 2012–2014 in maternity hospitals in mai...

Background According to the guidelines, surgical aortic valve replacement (SAVR) is recommended in patients at low surgical risk (EuroSCORE II < 4%), whereas for other patients, the decision between transcatheter aortic valve implantation (TAVI) and surgery should be made by the Heart Team, with TAVI being favoured in elderly patients. Aim The RAC...

Background Despite the high prevalence of child abuse and neglect and its consequences on health, very few studies have evaluated the trajectories of children in placement in France, and there are no cost studies available. Objective To estimate the cost of abuse and neglect in children in placement before their 4th birthday in France. Participan...

Background Human Papillomavirus (HPV) vaccine coverage in France is below 30%, despite proven effectiveness against HPV infections and (pre-)cancerous cervical lesions. To optimise vaccine promotion among adolescents, we used a discrete choice experiment (DCE) to identify optimal statements regarding a vaccination programme, including vaccine chara...

Objectives We evaluated how next generation sequencing (NGS) can modify care pathways in an observational impact study in France. Methods All patients with lung cancer, colorectal cancer, or melanoma who had NGS analyses of somatic genomic alterations done in 1 of 7 biomolecular platforms certified by the French National Cancer Institute (INCa) be...

Background: To identify deprivation indicators usable in everyday practice and included in medico-administrative databases, particularly with infectious diseases, which represent the greatest proportion of hospitalizations. Our objective was to compare ecological indicators to individual questionnaires and apply both types to the study of the impa...

Objectives: Studies have shown a consistent impact of socioeconomic status at birth for both mother and child; however, no study has looked at its impact on hospital efficiency and financial balance at birth, which could be major if newborns from disadvantaged families have an average length of stay (LOS) longer than other newborns. Our objective...

Background People suffering from mental disorders are in poorer somatic health that the general population. This is due in part to poor quality of care in primary care settings, which can in turn have a major impact on hospitals and healthcare systems, in particular in terms of costs. Our objective was to assess the economic burden of acute care ad...

Background Transcatheter aortic valve replacement (TAVR) is a relatively new alternative to open surgery in patients with a severe aortic stenosis at high risk of surgery but there are important variations in treatment delay which can lead to increased morbidity and mortality. Those delays have many causes, including patients’ unawareness of the ur...

Background In healthcare systems where hospital tariffs are based on average national length of stay (LOS), deprived patients may be a source of inefficiency for hospitals as deprivation has been shown to be associated with increased LOS. They may also negatively impact hospitals’ financial balance as few hospital payment methods include deprivatio...

Importance In health care systems in which hospital reimbursement is based on a national mean length of stay (LOS), disadvantaged patients with an increased LOS may be a source of inefficiency. This implication has been reported in adult patients, but pediatric data have been scarce. Objective To examine the association of patient socioeconomic st...

Introduction En France, une personne sur cinq a connu ou connaîtra un épisode dépressif au cours de sa vie. Le fardeau épidémiologique et économique de la maladie pose donc de grands défis aux systèmes de santé, tout comme l’accès aux soins des patients. En effet, il est estimé que la moitié de la population atteinte de dépression n’est pas traitée...

Introduction De nombreuses études chez l’adulte ont montré que la précarité était associée à une durée de séjour augmentée et un surcoût pour les établissements de santé. Dans un système de santé où les tarifs hospitaliers sont fixés autour d’une durée moyenne de séjour (DMS) nationale, les patients précaires pourraient donc être source d’inefficie...

Introduction Les personnes atteintes de troubles mentaux ont une espérance de vie plus faible et une prévalence de pathologies somatiques plus fréquente que la population générale du fait des multiples barrières auxquelles elles doivent faire face pour accéder aux soins. Notre objectif était d’évaluer l’impact des troubles mentaux sur la qualité de...

Introduction Dans les études évaluant des stratégies thérapeutiques, l’évaluation médico-économique impose le recueil et la valorisation de la consommation de soins. Aujourd’hui, deux méthodes de recueil sont principalement utilisées : le cahier d’observation du patient (CRF) pour les soins ambulatoires et les données locales du programme de médica...

Abstract Background Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants...

Purpose Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible for poor long-term outcomes wou...

Conference on Molecular Analysis for Personalised Therapy (MAP), Paris, FRANCE, SEP 14-15, 2018

Background: Adult deprived patients consume more healthcare resources than others, particularly in terms of increased length of stay (LOS) and costs. Very few pediatric studies have focused on LOS, although the effect of deprivation could be greater in children due to the vulnerability of this population. Our objective was to compare LOS between d...

Aims People with a mental illness have a shorter lifespan and higher rates of somatic illnesses than the general population. They also face multiple barriers which interfere with access to healthcare. Our objective was to assess the effect of mental illness on the timeliness and optimality of access to healthcare for somatic reasons by comparing in...

Background: Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution of the treatment of patients with aortic stenosis at the nationwide level are scarce. Objectives: This study sought to evaluate the number of aortic valve replacements (AVRs) p...

Objectives: The aim was to assess the cost-effectiveness of fenestrated and branched stent grafts (f/b EVAR) compared with open surgical repair (OSR) in thoraco-abdominal or complex abdominal aortic aneurysms (TAAA/AAA) at 2 years. Methods: Two matched cohorts of patients with TAAA or complex AAA were compared after a follow-up of two years. Pat...

Introduction Les personnes atteintes de troubles mentaux ont une esperance de vie diminuee de 20 ans par rapport a la population generale et presentent egalement une forte prevalence de pathologies somatiques. Cependant, elles ont moins d’acces a la medecine preventive et leurs troubles somatiques sont souvent pris en charge tardivement. Les causes...

Objectives Our goal was to provide data on the economic burden and health-related quality of life (HRQOL) of patients with cystic fibrosis (CF) and their caregivers in Europe. Methods A cross-sectional study was carried out on adults and children with CF in eight European countries. Patients completed an anonymous questionnaire regarding their soc...

To compare 30 day outcomes and costs of fenestrated and branched stent grafts (f/b EVAR) and open surgery (OSR) for the treatment of complex abdominal aortic aneurysms (AAA) and thoraco-abdominal aortic aneurysms (TAAA). The multicenter prospective registry WINDOW was set up to evaluate f/b EVAR in high risk patients with para/juxtarenal AAA, and i...

Background: Our goal was to provide data on the economic burden and health-related quality of life (HRQoL) associated with cystic fibrosis (CF) in France. Methods: A retrospective cross-sectional study was carried out on adults and children with CF, who completed an anonymous questionnaire regarding their socio-demographic characteristics, healt...

Orphan drugs target small populations of patients. In order to make the field more attractive to pharmaceutical companies and encourage R&D in rare diseases, incentives were put forward by the EU, which are discussed in this article. Because they often are the only available option to treat a disease, some orphan drugs are considered to have high v...

The deterministic character of radiation-induced cataract is being called into question, raising the possibility of a risk in patients, especially children, exposed to ionizing radiation in case of repeated head CT-scans. This study aims to estimate the eye lens doses of a pediatric population exposed to repeated head CTs and to assess the feasibil...

The eye is well known to be sensitive to clearly high doses (>2 Gy) of ionizing radiation. In recent years, however, cataracts have been observed in populations exposed to lower doses. Interventional cardiologists are repeatedly and acutely exposed to scattered ionizing radiation (X-rays) during the diagnostic and therapeutic procedures they perfor...