Dijon Justine, Sarazin Marianne, Augusto Vincent, Franck Thomas, Gonthier Régis, Célarier Thomas
Département de gérontologie clinique, Service de gérontologie clinique, Hôpital la charité, CHU Saint-Etienne, France.
Département d'information médicale, Centre Hospitalier Le Corbusier, Firminy, France, Centre ingénierie et santé, École nationale supérieure Saint-Étienne, France.
Geriatr Psychol Neuropsychiatr Vieil. 2018 Sep 1;16(3):255-262. doi: 10.1684/pnv.2018.0743.
Hospitalizations via the emergency services of the elderly represent on average 41% of the stays. The family physician is aware of the deleterious effects of using emergency rooms and know that intensive use contributes to the disorganization of these services. The provision of a telephone line, enabling doctors to have direct access to a geriatrician doctor, is a new service allowing, if necessary, direct hospitalization in geriatrics but its interest is still poorly evaluated.
From June 1st, 2015, to June 1st, 2016, we compared the route of care for inpatients directly in short stays of geriatrics thanks to the hotline (group hotline) versus the route of those passed by emergencies (group EU, emergency unit).
520 patients were included in the study. The duration of stay was shorter during hospitalization via the hotline, 11.6 [95% CI, 10.8-12.3] days in a direct hospitalization versus 14.1 [95% CI, 13.5-14.7] days of a passage through emergencies (p <0.05). Patients who were admitted to the emergency room were more likely to be hospitalized again. Among the 170 patients re-hospitalized, an average duration before re-hospitalization of 29.5 [CI 95%, 23.6-35.4] days was observed in patients hospitalised via the hotline, while those entered by emergencies were hospitalized in 24.1 [95% CI, 20.4-27.8] days (p <0.05).
This analysis suggests that the intra-hospital course of geriatric patients directly addressed in short stays of geriatrics by direct admission was shorter and more efficient than the course of an intermediate stage in the emergencies. It seems important to discuss the generalization of the hotline device for the functioning of the geriatric pathway.
通过急诊服务住院的老年人平均占住院总人数的41%。家庭医生了解使用急诊室的有害影响，并且知道频繁使用会导致这些服务的混乱。提供一条电话线，使医生能够直接联系老年病医生，这是一项新服务，必要时可直接入住老年病科，但这项服务的益处仍未得到充分评估。
从2015年6月1日至2016年6月1日，我们比较了通过热线直接入住老年病科短期住院患者（热线组）与通过急诊入院患者（急诊组，急诊单元）的治疗路径。
520名患者纳入研究。通过热线直接住院的患者住院时间较短，直接住院为11.6[95%可信区间，10.8 - 12.3]天，而通过急诊入院的为14.1[95%可信区间，13.5 - 14.7]天（p<0.05）。入住急诊室的患者再次住院的可能性更大。在170名再次住院的患者中，通过热线住院的患者再次住院前的平均时间为29.5[95%可信区间，23.6 - 35.4]天，而通过急诊入院的患者再次住院时间为24.1[95%可信区间，20.4 - 27.8]天（p<0.05）。
该分析表明，老年患者通过直接入住老年病科短期住院的院内病程比经过急诊中间阶段的病程更短、更有效。讨论将热线设备推广应用于老年病治疗路径的运作似乎很重要。
