Call patients furthest from the health system to raise awareness about cancer screening: given the French delay in this area, Health Insurance decided to expand an experiment started in 2008 in the Dordogne.
“Hello ma’am, this is the Dordogne primary health insurance fund,” recites one of the twelve advisors at the Périgueux call center. Next, he explains the detection protocol to the insured person and suggests, with his consent, that he make an appointment with the radiologist or order a colorectal cancer detection kit from a pharmacy.
“We ask the departmental funds to collaborate with health professionals, in particular radiology offices, to book appointments within fairly short periods,” explains the director of the CPAM of the Dordogne, Delphine Camblanne.
Since January, six other calling platforms, on which 112 advisors are distributed, speak with policyholders every day to encourage them to get tested.
Cervical, breast and colon cancer… The new national system focuses on the three diseases that are the subject of organized screening. In fact, France is struggling to achieve the goals set in Europe. In 2021-2022, the CNAM recorded a participation rate of 47.7% in breast cancer, well below the European target (70%).
More than a million calls
From January 1 to May 10, “more than one million calls were made nationwide,” says the CNAM. Of them, 235,086 insured people were able to receive assistance, of which just under half received an appointment.
The system responds “to the need to reach populations far from the health system,” according to Dr. Catherine Grenier, director of CNAM policyholders.
In the preferred age group for these examinations, the insured persons contacted meet one of these criteria: not having received reimbursed care in the last 24 months, not having a family doctor and/or benefiting from a combined supplementary health insurance.
To convince them, the advisors followed training given by the CPAM of Dordogne, chosen by the CNAM to coordinate these call platforms due to its experience acquired since 2008.
“The Dordogne has already made its platform available to all national funds to carry out campaigns for access to rights and care,” says Dr. Grenier.
“The novelty is that we now address prevention issues, while before the actions focused more on information campaigns about the rights of the insured,” he adds.
“Fear of results”
To fulfill this new mission, the Dordogne CPAM borrowed “motivational interviewing techniques” from Tarn, responsible for Sofia’s monitoring system for chronic diseases such as diabetes and asthma, explains Delphine Camblanne.
Equipped with scripts “validated by the medical world”, specifies Valérie Valignat, project management manager (MOAD) of the platforms “towards prevention”, the advisors have arguments to respond to the refusal of an insured.
“We ask open questions to generate an exchange,” explains Ingrid, advisor. “We treat each insured individually, listening to them and trying to reassure them as much as possible,” she adds, specifying that “fear of the results” constitutes the main obstacle to screening.
The information collected by the advisors will be used to more broadly assess obstacles and better target communication campaigns.
Appointment times and mobility limitations also complicate access to screening. Therefore, it is still too early to know whether policyholders have actually undergone a check by counting “the number of procedures reimbursed,” Camblanne points out.
In a press release published in mid-May, the CPAM of Dordogne assured, however, that among those surveyed, “half follow the approach” for colorectal cancer screening and “a quarter” for colorectal cancer screening. mom, making an appointment with the radiologist. .
Source: BFM TV
