Health in Val-de-Marne #19: new CPTS in Villejuif / Flu epidemic

A new territorial professional health community (CPTS) in Villejuif

Since the end of December, an eleventh CPTS (Territorial Professional Health Community) has been created in Val-de-Marne, in Villejuif. As a reminder, a CPTS brings together caregivers and health and medico-social actors in a city or a small group of cities. This joint work aims to identify health issues specific to the territory in order to provide practical solutions and prevention. These CPTS benefit from public funding depending on their scope and missions.

While Villejuif has more than 50,000 inhabitants and hosts several large hospitals: Gustave Roussy (cancer center), Paul Guiraud (psychiatric hospital) and Paul Brousse (geriatrics and liver), the CPTS focused on the only common, as is the case in Champigny-sur-Marne and Vitry-sur-Seine.

“The thinking had started before the health crisis but we really got around the table at the end of 2023”, testifies Laurence Heude, deputy director of health at Villejuif town hall. For the moment, the CPTS has around thirty members including a few doctors, pharmacies and institutions such as the municipal university health center or the Léo Lagrange health center.

Five main areas of work have been identified, explains Pierre-Louis Sokhn, general practitioner and co-president of the CPTS.

1° Access to care

The first is access to care. “There are currently 28 general practitioners in Villejuif with many retirements in perspective. One of our first subjects is therefore to integrate the patients of treating doctors who are going to leave,” illustrates the doctor. Added to this is the problem of patients who suffer from a long-term illness (ALD) and do not have a treating doctor.

The other major challenge in access to health is that of unscheduled care. A subject that will be covered “in coordination with the SAS (access to care system developed by the Regional Health Agency and the Samu) and the Sami of Villejuif (Initial medical reception service set up in Val-de-Marne by the council of the order of doctors).

2° Care pathway

The second line of work concerns the care pathway, notably through the streamlining of relationships between community doctors and hospitals, as well as the management of home support, coordinated with local medico-social organizations. The CPTS also wishes to work on perinatal care, for example, by relying on pharmacists to take stock of the vaccination status of pregnant women.

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3° Prevention

The third part concerns prevention. This could also rely on pharmacists, to be able to discuss, for example, the obstacles to cancer screening. It also involves going to schools, on topics of vaccination updates, sexual health, and even mental health.

4° Attractiveness of the territory

Fourth branch: the attractiveness of the territory. A very connected issue in terms of access to care, as the ability to attract new caregivers is essential to maintain medical demographics. “We have assets, advances Pierre-Louis Sokhn, recalling that the municipal health center like the Léo Lagrange medical office both work with doctors and academics, La Sorbonne for the first, Paris Saclay for the second, allowing new caregivers to connect to large university and research hospitals. The objective is “to instill a dynamic”, continues the doctor.

5° Manage health crises

The last point, which the CPTS does not forget, is the management of health crises. How to react, how to coordinate? So many questions to ask yourself in calm weather, to avoid being caught off guard.

For the moment, the new CPTS is being structured. A website will soon be deployed. In the meantime, the point of contact is an email address: [email protected]

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The flu continues to rage

The flu continues to rage throughout France, including in Ile-de-France, even if it seems to have passed its peak. The week of January 13 to 19 in Ile-de-France, it led to 3,534 visits to the emergency room, compared to 82 for Covid-19, 312 for bronchiolitis and 1,167 for gastroenteritis. At the national level, those aged 65 and over represent 67% of hospitalizations after going to the emergency room for flu/flu-like illness, indicates Santé Publique France.

However, emergency room visits for flu were down 11% from one week to the next. SOS doctors’ actions linked to flu, numbering 3,033, on the other hand increased by 5%. The positivity rate for the flu virus is also clearly decreasing, after peaking at the end of 2024. Compared to the 2023-2024 epidemic, this season’s flu hit a good month in advance.

Download the full epidemiological bulletin

In this context, the flu and Covid-19 vaccination campaign has been extended until February 28.

Below are the positivity rates for winter viruses in Île-de-France (Flu, SARS_Cov2, VRS) in hospitals (RENAL network)

Increases in consultation rates

Thirty euros at the general practitioner, 60 euros at the specialist if you are referred by a general practitioner: the price of certain consultations increased at the end of December, without impact for insured patients.

These increases are linked to the new agreement signed in June by Health Insurance and the unions of private doctors, to define their relations over the period 2024-2029.

The agreement providest “significant revaluations” for practitioners, with in return, actions to “transform the health system”in particular collective commitments on access to care and “relevance and quality” care, underlines the National Health Insurance Fund (Cnam).

The reference consultation for general practitioners has thus increased from 26.50 to 30 euros. At the same time, “the one-off consultant opinion”, which pays for the expertise provided by a specialist at the request of a general practitioner, increases from 56.50 to 60 euros.

Objective: to encourage the installation of doctors in town practices, by making the activity “plus attractive”particularly for general practitioners, who see a million patients per day.

These prices are reimbursed by Health Insurance (70%) and complementary insurance (30%), after deduction of the two euros of “flat rate participation” always owed by the patient (within the limit of 50 euros per year/patient). The 4% of French people who do not benefit from complementary health insurance will, however, see their out-of-pocket costs increase.

Increases among pediatricians, psychiatrists, geriatricians, etc.

Other consultations are concerned, in two stages. Faced with the deterioration of the mental health of young people in particular, the child psychiatry consultation is now paid 67 euros and will increase to 75 euros from July 1, compared to 54.70 previously. It will be usable until the patient is 25 years old.

In pediatrics, the three compulsory consultations for the child which require a “certificate” from the doctor have increased to 54 euros and will exceed 60 euros on July 1 (47.50 before). Other mandatory examinations (100% covered by Health Insurance) and routine follow-up consultations are also increased.

The agreement also created a new pediatric expertise consultation up to 16 years old, at 60 euros, upon referral (from a doctor, midwife, speech therapist, etc.) to strengthen early detection of developmental and mental disorders. chronic pathologies.

The classic consultation with psychiatrists increased to 55 euros, then 57 euros in the long term (51.70 before).

Increases are planned for other specialists including medical gynecologists (increased to €37 then 40 euros eventually compared to 33.50), geriatricians (€37 now then 42 euros compared to 31.50), neurologists (57 euros eventually compared to 51.70), for the screening of melanomas by dermatologists (60 euros compared to 47.50), or for various technical procedures.

“Improve access to care”

From 2026, general practitioners will receive a “treating doctor package” (additional remuneration in addition to the consultations carried out) simplified and calibrated on the composition of their patient base to promote in particular the care of elderly, precarious or chronically ill patients. The annual follow-up of a patient over 80 years old with a long-term illness will, for example, be valued at 100 euros.

In return, doctors commit to “ten numerical objectives” (reduce the rate of patients with long-term illnesses without a treating doctor to 2%, increase their patient base by 2% per year, etc.) and fifteen action programs to “relevance and quality” care (reduction in prescriptions for sick leave, certain medications, medical transport, etc.).

The results will be monitored by an observatory and published online every quarter, starting in the first quarter of 2025.

(AFP)

New building, AI, personalization of treatments… In Villejuif, Gustave Roussy aims to cure 80% of cancers by 2040

While the new Villejuif metro station opened this Saturday, January 18, suddenly making the Gustave Roussy Institute hyper accessible, the hospital-cancer research center is starting a very structuring year 2025, with the construction site its new research building, in parallel with the launch of research and targeted therapy programs. Objective: cure 80% of cancers by 2040. The challenge: understand and treat those of young adults, which are increasing.
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