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Master Thesis

Les soins palliatifs aux urgences : une réalité inévitable ? Analyse des passages aux urgences du centre hospitalier de Cayenne des patients en soins palliatifs suivis par l'HAD Guyane

Abstract : The priority in palliative care is the well being of patients and their close contacts, which seems to be incompatible with the care in the emergency department (ED). The aim was to determine if the Cayenne’s ED visits of patients receiving home palliative care were avoidable. This descriptive study was monocentric and retrospective over two years. Patients included were at least 15 years and 3 months old, receiving home care by HAD Guyane and who had visited at least once the Cayenne’s ED. Presentations were deemed avoidable if the symptoms were related to an expected worsening of their disease, when patients were very close to the end-of-life, when none urgent exam or treatment were necessary, when patients or their relatives requested a direct admission in a medical ward or when the problem could have been dealt at home if the home care team had been called. Among 127 patients receiving home palliative care, 61 visited the ED. Eighty visits were included and 47,5% were considered as avoidable. The ED presentations were more often avoidable when patients were alone at home (p<0,01), when patients came themselves to the ED (p=0,03) and when the doctor of the home care team had not been informed (p=0,02). The time of the visit and the call to the emergency care unit didn’t seem to be related to avoidable visits. This study confirm a significant proportion of avoidable visits to the ED. Some measures have been mentioned in this work to reduce avoidable visits. Besides, the experience of patients and relatives should be collected in future studies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01275139
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Submitted on : Tuesday, February 16, 2016 - 7:41:32 PM
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Clémence Wong ten Chin. Les soins palliatifs aux urgences : une réalité inévitable ? Analyse des passages aux urgences du centre hospitalier de Cayenne des patients en soins palliatifs suivis par l'HAD Guyane. Médecine humaine et pathologie. 2015. ⟨dumas-01275139⟩

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