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Renouncing care in French Guiana: the national health barometer survey
In French Guiana, health inequalities are patent for a broad range of pathologies for all age groups. The objective of the present study was to quantify the proportion of the population that had renounced care in the past year, to study predictive factors, and to compare results with other French te...
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| Published in: | BMC health services research 2019-02, Vol.19 (1), p.99-11, Article 99 |
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| creator | Van Melle, Astrid Cropet, Claire Parriault, Marie-Claire Adriouch, Leila Lamaison, Hélène Sasson, Francine Duplan, Hélène Richard, Jean-Baptiste Nacher, Mathieu |
| description | In French Guiana, health inequalities are patent for a broad range of pathologies for all age groups. The objective of the present study was to quantify the proportion of the population that had renounced care in the past year, to study predictive factors, and to compare results with other French territories.
A two-stage random sample of 2015 individuals aged 15 to 75 years was surveyed by telephone. A descriptive analysis of variables relative to renouncing care, use of health care, screening, and vaccination was initially performed. Multivariate analysis was then used to determine variables associated with renouncing care for financial reasons and renouncing for reasons linked to time were directly estimated using a Poisson model on weighted data. Variables with a significance level |
| doi_str_mv | 10.1186/s12913-019-3895-6 |
| format | article |
| fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_3bc33db047e7498c98ea106897be5541</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A581358061</galeid><doaj_id>oai_doaj_org_article_3bc33db047e7498c98ea106897be5541</doaj_id><sourcerecordid>A581358061</sourcerecordid><originalsourceid>FETCH-LOGICAL-c597t-6af79d562f3aaeee571d04d2e1d4c8a98fb973f551b9f527ebaca4efa82fd4263</originalsourceid><addsrcrecordid>eNptUktr1UAUDqLYWv0BbiTgxoWp88i8XAiX4m0LFwTR9XAyObmZSzJTJ0mh_97E1NpbZBYznPke5xy-LHtLyTmlWn4aKDOUF4SagmsjCvksO6WlYoU0kj9_9D7JXg3DgRCqNFMvsxNOFNOE89Ns-x1DnILzYZ87SJj7kG8TBtfml5OHAJ_zscU8wOhjgC5vEbqxzStIsccRUz5M6RbvXmcvGugGfHN_n2U_t19_XFwVu2-X1xebXeGEUWMhoVGmFpI1HAARhaI1KWuGtC6dBqObyijeCEEr0wimsAIHJTagWVOXTPKz7HrVrSMc7E3yPaQ7G8HbP4WY9hbS6F2HlleO87oipUJVGu2MRqBEaqMqFKKks9aXVetmqnqsHYYxQXckevwTfGv38dZKLiWhSzMfV4H2Ce1qs7M-DJh6SxhRgjJ6u_h9uPdL8deEw2h7PzjsOggYp8EyqrksqVFkhr5_Aj3EKc37X1GcG1Gqf6g9zPP60MS5TbeI2o3QlAtN5GJ7_h_UfGrsvYsBGz_Xjwh0JbgUhyFh8zAbJXbJnV1zZ-fc2SV3dlnFu8e7fGD8DRr_DSgm0Ss</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2183339547</pqid></control><display><type>article</type><title>Renouncing care in French Guiana: the national health barometer survey</title><source>NCBI_PubMed Central（免费）</source><source>ABI/INFORM Global</source><source>Publicly Available Content (ProQuest)</source><creator>Van Melle, Astrid ; Cropet, Claire ; Parriault, Marie-Claire ; Adriouch, Leila ; Lamaison, Hélène ; Sasson, Francine ; Duplan, Hélène ; Richard, Jean-Baptiste ; Nacher, Mathieu</creator><creatorcontrib>Van Melle, Astrid ; Cropet, Claire ; Parriault, Marie-Claire ; Adriouch, Leila ; Lamaison, Hélène ; Sasson, Francine ; Duplan, Hélène ; Richard, Jean-Baptiste ; Nacher, Mathieu</creatorcontrib><description>In French Guiana, health inequalities are patent for a broad range of pathologies for all age groups. The objective of the present study was to quantify the proportion of the population that had renounced care in the past year, to study predictive factors, and to compare results with other French territories.
A two-stage random sample of 2015 individuals aged 15 to 75 years was surveyed by telephone. A descriptive analysis of variables relative to renouncing care, use of health care, screening, and vaccination was initially performed. Multivariate analysis was then used to determine variables associated with renouncing care for financial reasons and renouncing for reasons linked to time were directly estimated using a Poisson model on weighted data. Variables with a significance level < 0.2 in the bivariate analysis were included in the full multivariate model.
In French Guiana, during the past 12 months, 30.9% of surveyed persons renounced care whatever the type for financial reasons. Results of the multivariate analysis showed that gender, perceived financial situation, perceived health and complementary insurance status were independent predictive factors of care renouncement for financial reasons. Overall, 24% of the surveyed population declared having renounced to care for time-related motives. The independent predictors for time-related renouncing were different than those for renouncing care for financial reasons: a higher education level and a poor perceived health were independently associated with time-related renouncement; retired persons and students were found to renounce care less frequently than persons with a job.
Renouncing for financial reasons, a major target of the 2016 health law, represented a public health problem in French Guiana. Renouncing for lack of time was an important motive for renouncing, which is aggravated by the insufficient number of health professionals, but may benefit from organizational solutions. There are avenues for improvement of health for the most vulnerable: promote health, act on risk factors, and facilitate the readability and accessibility of the health system. Recent reforms to stabilize health insurance may however have some adverse consequences for migrants.</description><identifier>ISSN: 1472-6963</identifier><identifier>EISSN: 1472-6963</identifier><identifier>DOI: 10.1186/s12913-019-3895-6</identifier><identifier>PMID: 30728033</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject><![CDATA[Adolescent ; Adult ; Aged ; Analysis ; Barometers ; Breast cancer ; Cancer ; Education ; Emergency medical care ; Female ; French Guiana ; Health care disparities ; Health care policy ; Health care reform ; Health Care Surveys ; Health disparities ; Health Expenditures - statistics & numerical data ; Health inequalities ; Health insurance ; Health insurance coverage ; Health screening ; Health services ; Health Status Disparities ; Health surveys ; Health system use ; Healthcare Disparities - statistics & numerical data ; HIV ; Human immunodeficiency virus ; Humans ; Immigrants ; Infectious diseases ; Insurance Coverage - statistics & numerical data ; Insurance, Health - statistics & numerical data ; Life Sciences ; Male ; Medical care utilization ; Medical personnel ; Medical prognosis ; Middle Aged ; Multivariate analysis ; National health insurance ; Noncitizens ; Patient care ; Population ; Public health ; Renouncing care ; Retirees ; Risk Factors ; Santé publique et épidémiologie ; Social aspects ; Socioeconomic Factors ; Surveys and Questionnaires ; Time Factors ; Transients and Migrants - statistics & numerical data ; Treatment Refusal - statistics & numerical data ; Vaccination ; Variables ; Young Adult]]></subject><ispartof>BMC health services research, 2019-02, Vol.19 (1), p.99-11, Article 99</ispartof><rights>COPYRIGHT 2019 BioMed Central Ltd.</rights><rights>2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>The Author(s). 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c597t-6af79d562f3aaeee571d04d2e1d4c8a98fb973f551b9f527ebaca4efa82fd4263</citedby><cites>FETCH-LOGICAL-c597t-6af79d562f3aaeee571d04d2e1d4c8a98fb973f551b9f527ebaca4efa82fd4263</cites><orcidid>0000-0001-9397-3204 ; 0000-0002-3925-6252 ; 0000-0001-9412-5952 ; 0000-0002-5503-8933</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366016/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2183339547?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11687,25752,27923,27924,36059,36060,37011,37012,44362,44589,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30728033$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-02075121$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Melle, Astrid</creatorcontrib><creatorcontrib>Cropet, Claire</creatorcontrib><creatorcontrib>Parriault, Marie-Claire</creatorcontrib><creatorcontrib>Adriouch, Leila</creatorcontrib><creatorcontrib>Lamaison, Hélène</creatorcontrib><creatorcontrib>Sasson, Francine</creatorcontrib><creatorcontrib>Duplan, Hélène</creatorcontrib><creatorcontrib>Richard, Jean-Baptiste</creatorcontrib><creatorcontrib>Nacher, Mathieu</creatorcontrib><title>Renouncing care in French Guiana: the national health barometer survey</title><title>BMC health services research</title><addtitle>BMC Health Serv Res</addtitle><description>In French Guiana, health inequalities are patent for a broad range of pathologies for all age groups. The objective of the present study was to quantify the proportion of the population that had renounced care in the past year, to study predictive factors, and to compare results with other French territories.
A two-stage random sample of 2015 individuals aged 15 to 75 years was surveyed by telephone. A descriptive analysis of variables relative to renouncing care, use of health care, screening, and vaccination was initially performed. Multivariate analysis was then used to determine variables associated with renouncing care for financial reasons and renouncing for reasons linked to time were directly estimated using a Poisson model on weighted data. Variables with a significance level < 0.2 in the bivariate analysis were included in the full multivariate model.
In French Guiana, during the past 12 months, 30.9% of surveyed persons renounced care whatever the type for financial reasons. Results of the multivariate analysis showed that gender, perceived financial situation, perceived health and complementary insurance status were independent predictive factors of care renouncement for financial reasons. Overall, 24% of the surveyed population declared having renounced to care for time-related motives. The independent predictors for time-related renouncing were different than those for renouncing care for financial reasons: a higher education level and a poor perceived health were independently associated with time-related renouncement; retired persons and students were found to renounce care less frequently than persons with a job.
Renouncing for financial reasons, a major target of the 2016 health law, represented a public health problem in French Guiana. Renouncing for lack of time was an important motive for renouncing, which is aggravated by the insufficient number of health professionals, but may benefit from organizational solutions. There are avenues for improvement of health for the most vulnerable: promote health, act on risk factors, and facilitate the readability and accessibility of the health system. Recent reforms to stabilize health insurance may however have some adverse consequences for migrants.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Barometers</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Education</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>French Guiana</subject><subject>Health care disparities</subject><subject>Health care policy</subject><subject>Health care reform</subject><subject>Health Care Surveys</subject><subject>Health disparities</subject><subject>Health Expenditures - statistics & numerical data</subject><subject>Health inequalities</subject><subject>Health insurance</subject><subject>Health insurance coverage</subject><subject>Health screening</subject><subject>Health services</subject><subject>Health Status Disparities</subject><subject>Health surveys</subject><subject>Health system use</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immigrants</subject><subject>Infectious diseases</subject><subject>Insurance Coverage - statistics & numerical data</subject><subject>Insurance, Health - statistics & numerical data</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical care utilization</subject><subject>Medical personnel</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>National health insurance</subject><subject>Noncitizens</subject><subject>Patient care</subject><subject>Population</subject><subject>Public health</subject><subject>Renouncing care</subject><subject>Retirees</subject><subject>Risk Factors</subject><subject>Santé publique et épidémiologie</subject><subject>Social aspects</subject><subject>Socioeconomic Factors</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><subject>Transients and Migrants - statistics & numerical data</subject><subject>Treatment Refusal - statistics & numerical data</subject><subject>Vaccination</subject><subject>Variables</subject><subject>Young Adult</subject><issn>1472-6963</issn><issn>1472-6963</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>M0C</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUktr1UAUDqLYWv0BbiTgxoWp88i8XAiX4m0LFwTR9XAyObmZSzJTJ0mh_97E1NpbZBYznPke5xy-LHtLyTmlWn4aKDOUF4SagmsjCvksO6WlYoU0kj9_9D7JXg3DgRCqNFMvsxNOFNOE89Ns-x1DnILzYZ87SJj7kG8TBtfml5OHAJ_zscU8wOhjgC5vEbqxzStIsccRUz5M6RbvXmcvGugGfHN_n2U_t19_XFwVu2-X1xebXeGEUWMhoVGmFpI1HAARhaI1KWuGtC6dBqObyijeCEEr0wimsAIHJTagWVOXTPKz7HrVrSMc7E3yPaQ7G8HbP4WY9hbS6F2HlleO87oipUJVGu2MRqBEaqMqFKKks9aXVetmqnqsHYYxQXckevwTfGv38dZKLiWhSzMfV4H2Ce1qs7M-DJh6SxhRgjJ6u_h9uPdL8deEw2h7PzjsOggYp8EyqrksqVFkhr5_Aj3EKc37X1GcG1Gqf6g9zPP60MS5TbeI2o3QlAtN5GJ7_h_UfGrsvYsBGz_Xjwh0JbgUhyFh8zAbJXbJnV1zZ-fc2SV3dlnFu8e7fGD8DRr_DSgm0Ss</recordid><startdate>20190206</startdate><enddate>20190206</enddate><creator>Van Melle, Astrid</creator><creator>Cropet, Claire</creator><creator>Parriault, Marie-Claire</creator><creator>Adriouch, Leila</creator><creator>Lamaison, Hélène</creator><creator>Sasson, Francine</creator><creator>Duplan, Hélène</creator><creator>Richard, Jean-Baptiste</creator><creator>Nacher, Mathieu</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>KB0</scope><scope>L.-</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9397-3204</orcidid><orcidid>https://orcid.org/0000-0002-3925-6252</orcidid><orcidid>https://orcid.org/0000-0001-9412-5952</orcidid><orcidid>https://orcid.org/0000-0002-5503-8933</orcidid></search><sort><creationdate>20190206</creationdate><title>Renouncing care in French Guiana: the national health barometer survey</title><author>Van Melle, Astrid ; Cropet, Claire ; Parriault, Marie-Claire ; Adriouch, Leila ; Lamaison, Hélène ; Sasson, Francine ; Duplan, Hélène ; Richard, Jean-Baptiste ; Nacher, Mathieu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c597t-6af79d562f3aaeee571d04d2e1d4c8a98fb973f551b9f527ebaca4efa82fd4263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Barometers</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Education</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>French Guiana</topic><topic>Health care disparities</topic><topic>Health care policy</topic><topic>Health care reform</topic><topic>Health Care Surveys</topic><topic>Health disparities</topic><topic>Health Expenditures - statistics & numerical data</topic><topic>Health inequalities</topic><topic>Health insurance</topic><topic>Health insurance coverage</topic><topic>Health screening</topic><topic>Health services</topic><topic>Health Status Disparities</topic><topic>Health surveys</topic><topic>Health system use</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immigrants</topic><topic>Infectious diseases</topic><topic>Insurance Coverage - statistics & numerical data</topic><topic>Insurance, Health - statistics & numerical data</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical care utilization</topic><topic>Medical personnel</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>National health insurance</topic><topic>Noncitizens</topic><topic>Patient care</topic><topic>Population</topic><topic>Public health</topic><topic>Renouncing care</topic><topic>Retirees</topic><topic>Risk Factors</topic><topic>Santé publique et épidémiologie</topic><topic>Social aspects</topic><topic>Socioeconomic Factors</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><topic>Transients and Migrants - 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Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BMC health services research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Melle, Astrid</au><au>Cropet, Claire</au><au>Parriault, Marie-Claire</au><au>Adriouch, Leila</au><au>Lamaison, Hélène</au><au>Sasson, Francine</au><au>Duplan, Hélène</au><au>Richard, Jean-Baptiste</au><au>Nacher, Mathieu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Renouncing care in French Guiana: the national health barometer survey</atitle><jtitle>BMC health services research</jtitle><addtitle>BMC Health Serv Res</addtitle><date>2019-02-06</date><risdate>2019</risdate><volume>19</volume><issue>1</issue><spage>99</spage><epage>11</epage><pages>99-11</pages><artnum>99</artnum><issn>1472-6963</issn><eissn>1472-6963</eissn><abstract>In French Guiana, health inequalities are patent for a broad range of pathologies for all age groups. The objective of the present study was to quantify the proportion of the population that had renounced care in the past year, to study predictive factors, and to compare results with other French territories.
A two-stage random sample of 2015 individuals aged 15 to 75 years was surveyed by telephone. A descriptive analysis of variables relative to renouncing care, use of health care, screening, and vaccination was initially performed. Multivariate analysis was then used to determine variables associated with renouncing care for financial reasons and renouncing for reasons linked to time were directly estimated using a Poisson model on weighted data. Variables with a significance level < 0.2 in the bivariate analysis were included in the full multivariate model.
In French Guiana, during the past 12 months, 30.9% of surveyed persons renounced care whatever the type for financial reasons. Results of the multivariate analysis showed that gender, perceived financial situation, perceived health and complementary insurance status were independent predictive factors of care renouncement for financial reasons. Overall, 24% of the surveyed population declared having renounced to care for time-related motives. The independent predictors for time-related renouncing were different than those for renouncing care for financial reasons: a higher education level and a poor perceived health were independently associated with time-related renouncement; retired persons and students were found to renounce care less frequently than persons with a job.
Renouncing for financial reasons, a major target of the 2016 health law, represented a public health problem in French Guiana. Renouncing for lack of time was an important motive for renouncing, which is aggravated by the insufficient number of health professionals, but may benefit from organizational solutions. There are avenues for improvement of health for the most vulnerable: promote health, act on risk factors, and facilitate the readability and accessibility of the health system. Recent reforms to stabilize health insurance may however have some adverse consequences for migrants.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>30728033</pmid><doi>10.1186/s12913-019-3895-6</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9397-3204</orcidid><orcidid>https://orcid.org/0000-0002-3925-6252</orcidid><orcidid>https://orcid.org/0000-0001-9412-5952</orcidid><orcidid>https://orcid.org/0000-0002-5503-8933</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC health services research, 2019-02, Vol.19 (1), p.99-11, Article 99 |
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| subjects | Adolescent Adult Aged Analysis Barometers Breast cancer Cancer Education Emergency medical care Female French Guiana Health care disparities Health care policy Health care reform Health Care Surveys Health disparities Health Expenditures - statistics & numerical data Health inequalities Health insurance Health insurance coverage Health screening Health services Health Status Disparities Health surveys Health system use Healthcare Disparities - statistics & numerical data HIV Human immunodeficiency virus Humans Immigrants Infectious diseases Insurance Coverage - statistics & numerical data Insurance, Health - statistics & numerical data Life Sciences Male Medical care utilization Medical personnel Medical prognosis Middle Aged Multivariate analysis National health insurance Noncitizens Patient care Population Public health Renouncing care Retirees Risk Factors Santé publique et épidémiologie Social aspects Socioeconomic Factors Surveys and Questionnaires Time Factors Transients and Migrants - statistics & numerical data Treatment Refusal - statistics & numerical data Vaccination Variables Young Adult |
| title | Renouncing care in French Guiana: the national health barometer survey |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T02%3A03%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Renouncing%20care%20in%20French%20Guiana:%20the%20national%20health%20barometer%20survey&rft.jtitle=BMC%20health%20services%20research&rft.au=Van%20Melle,%20Astrid&rft.date=2019-02-06&rft.volume=19&rft.issue=1&rft.spage=99&rft.epage=11&rft.pages=99-11&rft.artnum=99&rft.issn=1472-6963&rft.eissn=1472-6963&rft_id=info:doi/10.1186/s12913-019-3895-6&rft_dat=%3Cgale_doaj_%3EA581358061%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c597t-6af79d562f3aaeee571d04d2e1d4c8a98fb973f551b9f527ebaca4efa82fd4263%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2183339547&rft_id=info:pmid/30728033&rft_galeid=A581358061&rfr_iscdi=true |