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Who are the patients consulting general practitioners in the municipal health centers of the city of XXX (Paris area), and where do they come from?

Eva KOZUB

Territorial health inequalities tend to worsen with the scarcity of medical provision. This scarcity varies across territories, whereas access to care should be as open as possible, especially in General Practice (GP), the entry point into the healthcare pathway. The city of XXX (Paris area) is particularly affected by this phenomenon, while its economically disadvantaged population has significant health needs. Rooted in a long history, the four municipal health centers (CMS) of this city attempt to offer the most inclusive access possible to fight against these inequalities.To describe the GP patient population of the XXX CMS and the territorial anchoring of these centers.This retrospective observational cross-sectional study was conducted using administrative data extracted from the practice management software common to the four CMS in Paris area. The individual and ecological characteristics of patients who consulted at least once a GP in 2022 were described. Maps were produced to visualize the territorial anchoring of each CMS.13,072 patients from 43,116 GP consultations were analyzed. The patient population of the XXX CMS is varied and is not limited to the city's inhabitants. More than a third of the patients possess means-tested health insurance, and more than half live in a socially very deprived neighborhood according to the FDep ecological social deprivation index. Two types of territorial anchoring emerge depending on whether the centers are located at the crossroads of human mobility or within isolated areas.Being limited to administrative data, this study lacks information regarding the health status of this population. The population consulting in these centers appears more precarious than the national average. Various mechanisms, such as familiarity with the location, could explain the centers' attractiveness, notably for patients not living in the city or those who have moved away.Better understanding the population consulting in GP and the territorial anchoring of the XXX CMS allows for grasping the specificities of the territories they serve, while enabling the implementation of actions aimed at reaching those who do not visit them, who are potentially excluded from care.