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Master Thesis

Évaluation de la pertinence des admissions aux urgences de l'Hôpital d'Instruction des Armées Robert Picqué

Abstract : Introduction: The main objective of the study is to evaluate the appropriateness of admissions in the Teaching Military Hospital Robert Picqué (TMHRP) services through the emergency department. The secondary objective is to identify the main causes of inappropriateness and possible contributing factors to propose corrective measures. Method: This is a mono-centric analytical epidemiological study including all patients hospitalized in one of the TMHRP services through emergencies between September, 9th and October, 7th 2013 (4 weeks). The tool used is the French version of the Appropriateness Evaluation Protocol (AEPf) and the doctor in charge of the hospitalized patients has filled a sheet of collection. The analysis of medical records considered inappropriate was performed by the expert (justification or causes of inappropriateness). Results: 255 patients were included. The appropriate admission rate is 86% with AEPf tool and 87% after the expert opinion. Among the patient hospitalized in inappropriate and unjustified way, 25% needed a diagnostic or therapeutic procedure and 25% did not require any care or service. The main reason for these inappropriate admissions is a problem in the organization of care for 60% of patients. According to the statistical analysis, the patients less than 50 years (0,289[0,135;0,619]) and even more so less than 30 years (0,171[0,067;0,439]), admitted to medical HIARP services (0,309[0,128;0,744]) are the patients most at risk of being admitted inappropriately. Conclusion: The emergency department of HIARP has a rate of inappropriate admissions comparable to those observed in the literature. An action plan could reduce this rate: creation of analysis of professional practice sessions and icon facilitating access to specialist consultations and presence of a radiologist permanently on site.
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Master Thesis
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Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, December 10, 2014 - 4:25:00 PM
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  • HAL Id : dumas-01093454, version 1



Clémentine Chamelat. Évaluation de la pertinence des admissions aux urgences de l'Hôpital d'Instruction des Armées Robert Picqué. Médecine humaine et pathologie. 2014. ⟨dumas-01093454⟩



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