Excess mortality and hospitalizations of transitional-age youth with a long-term disease in France

The number of young people with a severe chronic disease has risen in high-income countries due to improvements in the prognosis of childhood-onset chronic conditions. In response to this situation, Antoine Rachas, Philippe Tuppin, Laurence Meyer, Bruno Falissard, Albert Faye, Nizar Mahlaoui, Elise de La Rochebrochard, Marie Frank, Pierre Durieux and Josiane Warszawski, the authors of “Excess mortality and hospitalizations in transitional-age youths with a long-term disease (LTD): A national population-based cohort study”, sought to estimate the prevalence in France of 14-21- year-olds (the age bracket corresponding to the transition from adolescence to adulthood) who have such diseases and to assess their mortality and hospitalization risks relative to the same age bracket in the population at large.

To do so, a cohort study of 61,119 persons who turned 14 between 2005 and 2014 was conducted. The cohort was drawn from a national health insurance database that records all care received in France by approximately 1/100th of the country’s universal health insurance beneficiaries. The dataset also identifies and records treatment of LTDs (treatment entirely reimbursed by the health care system). The data identified 38 LTDs diagnosed before age 14.

Of the 61,119 persons in the sample, 3% had an LTD. The mortality rate for young people aged 14-21 was ten times higher among young patients with LTDs than among people in the same age bracket in the population at large.

Whereas male mortality was higher than female among young people with non-chronic disorders, that gap was smaller among young people with an LTD.

The probability of a short hospital stay (medical, surgical or obstetric) for young people in the population at large is 42.7%, as against 61.8% for young people with an LTD. However, probability falls sharply in the latter group after age 18.

Source: Antoine Rachas, Philippe Tuppin, Laurence Meyer, Bruno Falissard, Albert Faye, Nizar Mahlaoui, Elise de La Rochebrochard, Marie Frank, Pierre Durieux, Josiane Warszawski, 2018, "Excess mortality and hospitalizations in transitional-age youths with a long-term disease: A national population-based cohort study", Journal Plos One, March 2018.

Contacts: Antoine Rachas, Philippe Tuppin, Laurence Meyer, Bruno Falissard, Albert Faye, Nizar Mahlaoui, Elise de La Rochebrochard, Marie Frank, Pierre Durieux, Josiane Warszawski

Online: November 2018