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Master Thesis

Impact d’un avis médical initial sur la gravité et la trajectoire de soin des enfants aux urgences pédiatriques de Périgueux

Abstract : Introduction: The Pediatric Emergency Department (PED) has been seeing a sharp increase of its activities for many years whereas the hospitalization rate has been rising at a slower pace. The main purpose of this study was to assess the impact of an initial medical opinion on the severity and the care trajectory of children in the PED of Périgueux, prefecture of the Dordogne department that lacks general practitioners (GP) and private pediatricians. The second purpose was to take stock of the chief complaints and the most frequent diagnoses. Material and methodology: A monocentric descriptive prospective study carried out between January 27th and March 6th 2014, from 9AM to 8PM, involving 500 children who arrived in succession and without appointment. The data was gathered via a questionnaire filled out by the medical staff. Results: 69% of patients spontaneously came to the PED. 61.4% were categorized as CCMU 1. 82.2% of children (referred or not) were sent home after the consultation versus 86.4% for non-addressed. When children were referred by a GP (none were addressed by a pediatrician) or were given a medical opinion over the phone, the proportion of children categorized as CCMU 2 or 3 was significantly higher, so was the proportion of children being hospitalized: 26.9% following a medical consultation, 25.9% following the phone call versus only 9.3% for non-referred patients. Most patients lived around the hospital and 48.4% of non-referred children lived less than 15 minutes away from the PED. Conclusion: Being referred by a GP or a pediatrician to the PED needs to be one of the severity criteria. There are means of improvement to better manage the flow of patients going to the PED, namely: educating young parents, using an efficient sorting criteria grid, developing out-of-hours medical services, but also adapting the healthcare system to users’ needs.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01202587
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Submitted on : Monday, September 21, 2015 - 1:40:08 PM
Last modification on : Wednesday, August 23, 2017 - 4:30:35 PM
Long-term archiving on: : Tuesday, December 29, 2015 - 8:58:01 AM

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Julie Scandella. Impact d’un avis médical initial sur la gravité et la trajectoire de soin des enfants aux urgences pédiatriques de Périgueux. Médecine humaine et pathologie. 2015. ⟨dumas-01202587⟩

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