French In Public
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France Télévisions is currently funded by the revenue from television licence fees and commercial advertising. The new law on public broadcasting will phase out commercial advertising on the public television channels (at first in the evening, then gradually throughout the day).
In August 2000, France Télévisions S.A. was formed as a holding company for France's public television channels, absorbing control of France 2, France 3, and La Cinquième (later renamed France 5). In 2004, Réseau France Outre-mer was absorbed by France Télévisions. Beginning in 2008, the President of France took the duty of naming the presidents for the French public broadcasters; they were previously nominated by the Conseil supérieur de l'audiovisuel. In 2013, under Francois Hollande, the previously adopted law was modified to return the power to nominate the presidents or French public broadcasters to the Conseil supérieur de l'audiovisuel .
Role of public health insurance: Total health expenditures constituted 11.5 percent of GDP in 2017, which amounted to EUR 266 billion (USD 337 billion); 77 percent of those expenditures were publicly financed.3,4
Specialists working in public hospitals may see private-pay patients on either an outpatient or an inpatient basis, but they must pay a percentage of their earned fees to the hospital. A 2013 report estimated that 10 percent of the 46,000 hospital specialists in surgery, radiology, cardiology, and obstetrics had treated private patients.
Private, for-profit clinics owned either by individuals or, increasingly, by large corporations have the same funding mechanism as public hospitals, but the share of respective payers differs. Physician fees are billed in addition to the DRG in private clinics, and DRG payment rates are lower there than they are in public or nonprofit hospitals.
Mental health care: Services for people with mental illness are provided by both the public and the private health care sector, with an emphasis on community-based provision. Public care is provided within geographically determined areas and includes a wide range of preventive, diagnostic, and therapeutic inpatient and outpatient services. Ambulatory centers provide primary ambulatory mental health care, including home visits.
SHI covers mental health care provided by GPs and psychiatrists in private practice, public mental health care clinics, and private psychiatric hospitals. Care provided by psychologists, psychotherapists, or psychoanalysts is fully paid by patients or covered by VHI. Copayments and the flat-rate fee for accommodation can also be fully covered by VHI. Copayments do not apply to persons with diagnosed long-term psychiatric disorders, including schizophrenia, bipolar disorder, severe anxiety, and depression.
Institutional long-term care is provided in retirement homes and long-term care units, totaling roughly 10,000 institutions with a total of 728,000 beds.10 Of these institutions, currently 54 percent are public, 28 percent private nonprofit, and 18 percent for-profit, although the percentage of for-profit institutions is increasing.
Population health surveys are undertaken based on disease, population segment (such as newborns, students, elderly patients), or theme (like nutrition). In addition, there are regional disease-based registries for specific conditions, including cancer, multiple sclerosis, and congenital abnormalities. The CONSTANCES Cohort is a 200,000-person representative sample of the population, surveyed yearly with linkages to the national claims database. National surveys showing regional variations in health and access to health care are publicly reported.
The mounting discontent over excessive balance billing revealed in the press, together with claims by private clinics of unfair competition, has prompted several public inquiries. The latest inquiry resulted in recommendations to increase public control over these activities.
13 DREES, Médecins libéraux : une hausse modérée de leurs revenus entre 2011 et 2014 (Ministère des Affaires sociales et de la Santé, Nov. 2017), -sante.gouv.fr/etudes-et-statistiques/publications/etudes-et-resultats/article/medecins-liberaux-une-hausse-moderee-de-leurs-revenus-entre-2011-et-2014; accessed June 2019.
The Teaching Assistant Program in France offers you the opportunity to work in France for 7 months, teaching English to French students of all ages. Each year, about 1,500 American citizens and permanent residents teach in public schools across all regions of metropolitan France and in the overseas departments of France such as French Guiana, Guadeloupe, Martinique and Réunion. The American cohort is part of the larger Assistants de langue en France program, which recruits approximately 4,500 young educators from 68 countries to teach 15 languages annually in France. The Assistants de langue en France program is managed by France Éducation international.
After a year in France, Teaching Assistants pursue global careers in education, international business, public health, international policy and development, arts and culture administration, among other fields. There are over 30,000 TAPIF Alumni across the U.S.
Every year nearly 1,500 new TAPIF participants travel to France to take advantage of this unique opportunity to live in France to improve their French proficiency level and discover the teaching profession. They are able to spend 7 months teaching English to French students of all ages in French public schools both in metropolitan France as well as the overseas departments.
Hospitals in the public and private sectors tend to join larger organizations to form hospital groups. This increasingly frequent mode of functioning raises the question of how countries should organize their health system, according to the interactions already present between their hospitals. The objective of this study was to identify distinctive profiles of French hospitals according to their characteristics and their role in the French hospital network.
The French hospital network is organized around three categories of public hospitals, with an unbalanced and disassortative patient flow. This type of organization has implications for hospital planning and infectious diseases control.
In 2016, the French Public Health law no 2016-41 for the improvement of the healthcare system made it compulsory for hospitals to join a Regional Hospital Group (RHG). This law was followed by the creation of 136 collaborative hospital networks, each one having a designated leader. Before this law, the regional health agencies lacked access to information regarding transfers and patient flow between hospitals. Policymakers need to be able to determine if new laws and regulations have the desired effect, and they will attempt to make amendments to the text if they have not achieved what was aimed for. However, this process presupposes some degree of knowledge about the system for which the regulation is intended. Any attempt to reform public hospital systems needs to be based on an analysis of hospital data, be it local or foreign, as the experience of other countries may provide useful models for future regulation. The analysis of hospital data may often start as a description of the hospitals that are part of the system. Hospitals can be considered as individual entities or as parts of broader networks. Previous work has shown that the number of patients shared between physicians can predict relationships between medical providers . Likewise, Social Network Analysis conducted on administrative hospital data can allow the identification of relations between hospitals . These relationships can be inferred from the observation of frequent patient transfers, which denote a certain degree of trust between hospitals and are a valid proxy for the ability to collaborate for the benefit of the patient [15, 16]. Direct transfers are frequent: 1 million in France in 2014 . They represent 6.4% of patient admitted to Intensive Care Units in the United States . They tend to have longer lengths of stay and cost more than twice as much as those not transferred, which makes them of particular interest to hospital managers . Understanding the patterns of patient mobility between hospitals is a first step towards the optimization of interactions between hospitals. Although network-level variables have not been consistently associated with quality of care, an increasing number of publications suggest such a relationship [14, 16]. Integration (distributed goals) and differentiation (coordination of specialization) are frequent in efficient organizations . However, these properties have seldom been studied in real-world healthcare systems [21, 22], despite recent work calling for such studies . The characteristics of hospital transfers need to be identified to ascertain how these transfers occur in relation to integrated hospital networks. The objective of this study was to use unsupervised learning methods and social network analysis to identify clusters of French public hospitals according to their characteristics and their role in the national hospital network, by taking into account patient transfers within Regional Hospital Groups in the clustering algorithm. A secondary objective was to describe patterns of patient mobility between these hospitals.
French public hospitals were described using two complementary methods. First, a cluster analysis was conducted to identify distinctive hospital profiles; then a Social Network Analysis was conducted to understand how these profiles interacted in the hospital network.
Clusters of hospitals were determined using the k-means method. This algorithm has the advantage of being applicable to numerical data, performs well when data are of good quality, and is easy to understand . The principle of this algorithm is to choose a number K of centroids that corresponds to the number of clusters. The initial centroids a