Since 1 January 2016, the Auvergne and Rhone-Alpes regions have merged as part of the territorial reform. The new region is composed of 12 departments and accounts for more than 8 million inhabitants. Its territory is heterogeneous in population density with very urban areas (Clermont-Ferrand, Grenoble, Lyon and Saint-Etienne) and important mountainous areas (Arc Alpin, Massif Central). In France since 2004, the syndromic surveillance system SurSaUD® [1] coordinated by the French Public Health Agency (Sant© publique France) collects morbidity data on a daily basis from two data sources: the emergency departments (ED) network Oscour® and the emergency general practitioners SOS Medecins associations. In Auvergne-Rhone-Alpes, the number of structures participating in the scheme has gradually increased from 2006 to today; as of 1 September 2018, all emergency services (N = 84) and all SOS ©decins associations (N = 7) transmit their data on a daily basis. Both data sources collect medical diagnoses, using ICD10 codes in the ED network and specific medical thesaurus in SOS Medecins Associations. These data are routinely analyzed to detect and follow-up various expected or unusual public health events all over the territory [2]. A reflection on the analysis of monitoring data at the sub-regional level was conducted in the region in order to refine the analyses carried out and better meet the expectations of local partners.

Objective: Define analytic areas at a sub-regional level to better meet the needs of local decision-makers.