LINKING FRENCH HOSPITAL DISCHARGE DATA TO OPEN-SOURCE EXPOSOME DATA : A USE CASE ON COPD AND ASTHMA
Author(s)
Nicolas Molinari, PhD1, Christiane Pochulu, Petiente-experte2, Isabella Annesi-Maesano, PhD3, Lea Antoniali, PharmD4, Olivia Carnapete, MSc4, Aurélie Chekroun Martinot, MSc5, Rosa Falotico, PhD5, Floriane Huret, PharmD4, Véronique Marcade-Fulcrand, PharmD4, Mathieu Rose, MSc4, Thomas Séjourné, MSc4, Priscille de la tour, PharmD6, Colas Tcherakian, PhD7.
1CHU Montpellier, Montpellier, France, 2Association “Santé Respiratoire France”, paris, France, 3Immuno4Care, Montpellier, France, 4Sanofi, Gentilly, France, 5Alira Health, Paris, France, 6Sanofi, Lyon, France, 7Hôpital Foch, Paris, France.
1CHU Montpellier, Montpellier, France, 2Association “Santé Respiratoire France”, paris, France, 3Immuno4Care, Montpellier, France, 4Sanofi, Gentilly, France, 5Alira Health, Paris, France, 6Sanofi, Lyon, France, 7Hôpital Foch, Paris, France.
OBJECTIVES: A real-world study based on PMSI (Programme de médicalisation des systèmes d'information - French hospital discharge database) and open-source environmental and socioeconomic data, known as exposome data, was set up in France between 2018 and 2022. The objective of the study is to leverage PMSI and open-source data to assess exposome factors associated with severe COPD and asthma exacerbation.
METHODS: A multidisciplinary expert group developed a linkage method between PMSI and open-source data. Exposome factors were categorized into fixed factors (F), which remain consistent over time, and non-fixed factors (NF), which fluctuate over time. Fixed factors were linked to patients by municipality, while NF were linked by matching each patient’s PMSI postcode to the nearest monitoring station using the nearest-neighbor method. Severe COPD and asthma exacerbation-related hospitalizations were identified using disease-specific ICD-10 codes algorithms. Associations between exposome factors and severe exacerbation risk were performed on the assed with univariate conditional logistic in matched case-control populations. Annual attributable cost of each risk factor was estimated by multiplying the mean cost per admission by the corresponding number of excess attributable hospitalizations.
RESULTS: This methodology identified 836,294 COPD patients and 477,534 asthma patients with at least one disease-related hospitalization. Among them, 162,729 COPD patients and 46,874 asthma patients experienced at least one severe exacerbation. A high level of poverty (≥10%) is associated with 8,243 additional exacerbations generating an incremental cost of €31 million and elevated level of greenhouse gases (CO2 equivalent/km2 >10,000) is associated with 3,969 additional exacerbations generating an economic burden of €74.5 million.
CONCLUSIONS: Exploring exposome helps improve clinical outcomes while enhancing cost-efficiency in the healthcare system. This study presents a framework for future exposome studies integrating open-source data with the French hospital discharge database.
METHODS: A multidisciplinary expert group developed a linkage method between PMSI and open-source data. Exposome factors were categorized into fixed factors (F), which remain consistent over time, and non-fixed factors (NF), which fluctuate over time. Fixed factors were linked to patients by municipality, while NF were linked by matching each patient’s PMSI postcode to the nearest monitoring station using the nearest-neighbor method. Severe COPD and asthma exacerbation-related hospitalizations were identified using disease-specific ICD-10 codes algorithms. Associations between exposome factors and severe exacerbation risk were performed on the assed with univariate conditional logistic in matched case-control populations. Annual attributable cost of each risk factor was estimated by multiplying the mean cost per admission by the corresponding number of excess attributable hospitalizations.
RESULTS: This methodology identified 836,294 COPD patients and 477,534 asthma patients with at least one disease-related hospitalization. Among them, 162,729 COPD patients and 46,874 asthma patients experienced at least one severe exacerbation. A high level of poverty (≥10%) is associated with 8,243 additional exacerbations generating an incremental cost of €31 million and elevated level of greenhouse gases (CO2 equivalent/km2 >10,000) is associated with 3,969 additional exacerbations generating an economic burden of €74.5 million.
CONCLUSIONS: Exploring exposome helps improve clinical outcomes while enhancing cost-efficiency in the healthcare system. This study presents a framework for future exposome studies integrating open-source data with the French hospital discharge database.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MSR34
Topic
Epidemiology & Public Health, Methodological & Statistical Research, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)