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Administration des transfusions sanguines à l'hôpital ou à domicile ? Le choix des patients atteints de cancer

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  • Marie-Odile Carrère

    (GATE - Groupe d'analyse et de théorie économique - UL2 - Université Lumière - Lyon 2 - ENS LSH - Ecole Normale Supérieure Lettres et Sciences Humaines - CNRS - Centre National de la Recherche Scientifique)

  • Yves Devaux

    (Centre Léon Bérard [Lyon])

  • Nathalie Havet

    (GATE - Groupe d'analyse et de théorie économique - UL2 - Université Lumière - Lyon 2 - ENS LSH - Ecole Normale Supérieure Lettres et Sciences Humaines - CNRS - Centre National de la Recherche Scientifique)

  • Magali Morelle

    (GATE - Groupe d'analyse et de théorie économique - UL2 - Université Lumière - Lyon 2 - ENS LSH - Ecole Normale Supérieure Lettres et Sciences Humaines - CNRS - Centre National de la Recherche Scientifique)

  • Raphaël Remonnay

    (GATE - Groupe d'analyse et de théorie économique - UL2 - Université Lumière - Lyon 2 - ENS LSH - Ecole Normale Supérieure Lettres et Sciences Humaines - CNRS - Centre National de la Recherche Scientifique)

  • Valérie Kante

    (Centre Léon Bérard [Lyon])

Abstract

La réalisation de transfusions sanguines est fréquente au cours du traitement des pathologies cancéreuses. Une anémie et/ou une thrombopénie surviennent habituellement après une chimiothérapie et/ou un envahissement médullaire et caractérisent le plus souvent un stade avancé de la maladie cancéreuse où le pronostic vital peut être engagé à court terme. La grande majorité de ces transfusions sanguines ont lieu à l'hôpital, en hospitalisation de jour principalement. Néanmoins, certains établissements de transfusion sanguine disposent de centres de soins ou d'équipes mobiles pouvant pratiquer la transfusion sanguine à domicile (TAD). Par exemple, en collaboration avec l'établissement régional de transfusion sanguine Rhône-Alpes, le Centre de Lutte Contre le Cancer de Lyon - Léon Bérard (CLB) organise depuis plusieurs années une partie des transfusions sanguines de ses patients au domicile. Ces transfusions ont été développées dans le cadre plus global d'un réseau de soins à domicile et d'une structure d'hospitalisation à domicile coordonnés par l'hôpital, et qui prennent en charge une part importante des traitements anticancéreux (chimiothérapies, alimentation parentérale, antibiothérapie, contrôle de la douleur...). Le site transfusionnel de Lyon, appartenant à l'Etablissement Français du Sang (EFS) réalise près de 800 transfusions à domicile chaque année, et deux médecins transfuseurs participent à cette activité. En pratique, les modalités d'administration de la TAD sont les suivantes : pour les patients suivis par la coordination des soins à domicile du centre, le médecin coordinateur des soins à domicile décide, sur la base des numérations sanguines, de la nécessité d'une transfusion et la prescription est alors transmise à l'antenne transfusionnelle de l'EFS. Pour certains patients transfusés fréquemment, la décision peut être prise directement par le médecin transfuseur en concertation avec la coordination.Le médecin transfuseur de l'EFS prend alors rendez-vous avec le patient. Il apporte les produits sanguins au domicile, met en place la perfusion et reste pendant tout le temps d'administration le jour de la transfusion. S'il est indépendant du centre, le médecin transfuseur est donc identifié par les patients comme un professionnel de santé avec des compétences particulières dans la transfusion, travaillant en étroite collaboration avec la coordination des soins à domicile et avec lequel ils pourront être en rapports répétés.

Suggested Citation

  • Marie-Odile Carrère & Yves Devaux & Nathalie Havet & Magali Morelle & Raphaël Remonnay & Valérie Kante, 2008. "Administration des transfusions sanguines à l'hôpital ou à domicile ? Le choix des patients atteints de cancer," Post-Print halshs-00353328, HAL.
  • Handle: RePEc:hal:journl:halshs-00353328
    Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-00353328
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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    1. Nathalie Havet & Magali Morelle & Raphaël Remonnay & Marie-Odile Carrere, 2012. "Cancer patients’ willingness to pay for blood transfusions at home: results from a contingent valuation study in a French cancer network," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(3), pages 289-300, June.

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    Keywords

    transfusion sanguine; choix des patients;

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