SAINBIOSE laboratory, U1059 INSERM - University of Jean Monnet, Saint-Etienne, France.
Chaire Santé des Ainés, University of Jean Monnet, Saint-Etienne, France.
BMC Geriatr. 2023 Nov 28;23(1):783. doi: 10.1186/s12877-023-04495-9.
The Emergency unit of the hospital (Department) (ED) is the fastest and most common way for most French general practitioners (GPs) to respond to the complexity of managing older adults patients with multiple chronic diseases. In 2013, French regional health authorities proposed to set up telephone hotlines to promote interactions between GP clinics and hospitals. The main objective of our study was to analyze whether the hotlines and solutions proposed by the responding geriatrician reduced the number of hospital admissions, and more specifically the number of emergency room admissions.
We conducted a multicenter observational study from April 2018 to April 2020 at seven French investigative sites. A questionnaire was completed by all hotline physicians after each call.
The study population consisted of 4,137 individuals who met the inclusion and exclusion criteria. Of the 4,137 phone calls received by the participants, 64.2% (n = 2 657) were requests for advice, and 35.8% (n = 1,480) were requests for emergency hospitalization. Of the 1,480 phone calls for emergency hospitalization, 285 calls resulted in hospital admission in the emergency room (19.3%), and 658 calls in the geriatric short stay (44.5%). Of the 2,657 calls for advice/consultation/delayed hospitalization, 9.7% were also duplicated by emergency hospital admission.
This study revealed the value of hotlines in guiding the care of older adults. The results showed the potential effectiveness of hotlines in preventing unnecessary hospital admissions or in identifying cases requiring hospital admission in the emergency room. Hotlines can help improve the care pathway for older adults and pave the way for future progress.
Registered under Clinical Trial Number NCT03959475. This study was approved and peer-reviewed by the Ethics Committee for the Protection of Persons of Sud Est V of Grenoble University Hospital Center (registered under 18-CETA-01 No.ID RCB 2018-A00609-46).
医院（科）的急救部门（ED）是大多数法国全科医生（GP）应对管理患有多种慢性病的老年患者复杂性的最快和最常见的途径。2013 年，法国地区卫生当局提议设立电话热线，以促进全科医生诊所和医院之间的互动。我们研究的主要目的是分析热线和响应老年病医生提出的解决方案是否减少了住院人数，特别是减少了急诊室入院人数。
我们在 2018 年 4 月至 2020 年 4 月在法国七个研究点进行了一项多中心观察性研究。热线医生在每次通话后都要填写一份问卷。
研究人群包括符合纳入和排除标准的 4137 人。在参与者收到的 4137 个电话中，64.2%（n=2657）是咨询请求，35.8%（n=1480）是紧急住院请求。在 1480 个紧急住院请求中，285 个电话导致在急诊室住院（19.3%），658 个电话导致在老年短期停留（44.5%）。在 2657 个咨询/会诊/延迟住院请求中，9.7%的电话也因紧急住院而重复。
本研究揭示了热线在指导老年人护理方面的价值。结果表明，热线在预防不必要的住院或确定需要在急诊室住院的病例方面具有潜在的有效性。热线可以帮助改善老年人的护理途径，并为未来的进步铺平道路。
在临床试验编号 NCT03959475 下注册。本研究得到格勒诺布尔大学医院中心东南七区保护人伦理委员会的批准和同行评审（注册号 18-CETA-01 No.ID RCB 2018-A00609-46）。
