Costs of care for individuals with PIMD/polyhandicap in France in relation to the adequacy of care structure based on age and severity
Abstract
OBJECTIVE: The study aims to compare healthcare resource use per person with PIMD (profound intellectual and multiple disabilities)/polyhandicap receiving care either in specialised rehabilitation centres (SRCs) or residential facilities (RFs), and to study the effect of the adequacy for severity and age in relation with structure on the cost of care pathways. METHODS: Individuals included in the French national EVAL-PLH cohort with PIMD/polyhandicap and age at onset of cerebral lesion younger than 3 years old. Data were collected on the type of structure, patients' age and severity of health status, quality of life (PolyQoL scale), and health care use. Residential costs, outpatient visits, hospital admissions, intensive care unit stays and emergency attendances were measured. Mean annual costs and QoL scores were compared between SRCs and RFs in relation with the adequacy of care for age and severity. RESULTS: 618 patients (52% in RFs vs. 48% in SRCs) were included in the study (54% men, mean age 30 ± 17 years). The adequacy of the structure was not respected in 43% of cases. Compared to SRCs patients, RFs individuals spent 45% less on health care (mean costs €70,192 ± 34,301 vs. €157,736 ± 24,200; P < 0.001). In SRCs, overall care adequacy was associated with higher costs (P < 0.001). In RFs, significant higher costs were observed with inadequacy of care for severity (€81,205 ± 31,822 vs. €63,104 ± 33,905; P < 0.001). CONCLUSIONS: Incorporating health-economic criteria into patient-orientation decisions could improve the quality of care while reducing costs among patients with PIMD/polyhandicap.
Related
- Genomic variation in Sydowia polyspora in relation to geography and host symptom severity
- Importance of health indicators: Update for people with polyhandicap
- Initiative to federate research contributors: The Polyhandicap REsearch NEtwork PolyRENE
- Relation-Aware Graph-Hypergraph Networks for Antibody Sequence-Structure Co-Design
- Behaviorally prioritized entity-relation structure captures human visual cortical representations of natural scenes
BibTeX
@article{hamouda2026costs,
title = {{Costs of care for individuals with PIMD/polyhandicap in France in relation to the adequacy of care structure based on age and severity}},
author = {Ilyes Hamouda and Marie-Christine Rousseau and Anne Terraz Ayela and Any Beltran and Sibylle del Duca and Houria El Ouazzani and Souad Loukkal and Karine Baumstarck and Sandrine Loubiere},
journal = {Journal of Epidemiology and Population Health},
year = {2026},
month = oct,
doi = {10.1016/j.jeph.2026.203779},
url = {https://hal.science/hal-05774131v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Costs of care for individuals with PIMD/polyhandicap in France in relation to the adequacy of care structure based on age and severity
AU - Ilyes Hamouda
AU - Marie-Christine Rousseau
AU - Anne Terraz Ayela
AU - Any Beltran
AU - Sibylle del Duca
AU - Houria El Ouazzani
AU - Souad Loukkal
AU - Karine Baumstarck
AU - Sandrine Loubiere
PY - 2026
DA - 2026/10/01
JO - Journal of Epidemiology and Population Health
DO - 10.1016/j.jeph.2026.203779
UR - https://hal.science/hal-05774131v1
AB - OBJECTIVE: The study aims to compare healthcare resource use per person with PIMD (profound intellectual and multiple disabilities)/polyhandicap receiving care either in specialised rehabilitation centres (SRCs) or residential facilities (RFs), and to study the effect of the adequacy for severity and age in relation with structure on the cost of care pathways. METHODS: Individuals included in the French national EVAL-PLH cohort with PIMD/polyhandicap and age at onset of cerebral lesion younger than 3 years old. Data were collected on the type of structure, patients' age and severity of health status, quality of life (PolyQoL scale), and health care use. Residential costs, outpatient visits, hospital admissions, intensive care unit stays and emergency attendances were measured. Mean annual costs and QoL scores were compared between SRCs and RFs in relation with the adequacy of care for age and severity. RESULTS: 618 patients (52% in RFs vs. 48% in SRCs) were included in the study (54% men, mean age 30 ± 17 years). The adequacy of the structure was not respected in 43% of cases. Compared to SRCs patients, RFs individuals spent 45% less on health care (mean costs €70,192 ± 34,301 vs. €157,736 ± 24,200; P < 0.001). In SRCs, overall care adequacy was associated with higher costs (P < 0.001). In RFs, significant higher costs were observed with inadequacy of care for severity (€81,205 ± 31,822 vs. €63,104 ± 33,905; P < 0.001). CONCLUSIONS: Incorporating health-economic criteria into patient-orientation decisions could improve the quality of care while reducing costs among patients with PIMD/polyhandicap.
SN - 2950-4333
SN - 2950-4333
ER -