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Master Thesis

Médecin effecteur mobile : analyse descriptive des appels de 2015 au centre de réception et de régulation des appels du SAMU 22

Abstract : Background: Emergency Department (ED) use has been gradually increasing for several decades while the after-hours care has become deficient in the French department of Côtes d’Armor. To face this problem, a unit of mobile general practitioners (GP) has been established since 2012. The objectives of this study were to analyse the characteristics of the calls for mobile GP and to think about how the program could be improved. Method: Cross-sectional descriptive and analytic study based on a random sample of calls from the emergency call centre of Côtes d’Armor, resulting in a visit of the mobile GP, during the year 2015. Results: 419 patients were included. They were mainly elderly patients (76 ± 2 years) and female patients (56%). 60% of the visits took place at the patient’s home and 33% in nursing homes. The main activity took place during the week-end (daytime and evening). The most common reasons for the calls were deaths (22%), injuries caused by a fall (10%) and dyspneas (9%). 332 patients (79%) stayed home after the mobile GP visit while 87 patients (21%) were admitted to the emergency department. In bivariate analysis, women (p=0.0067), elderly patients (p= 0.0072) and those who lived in nursing home (p= 0.0021) were more likely to stay home after the mobile GP visit. However, in multivariate analysis, only the living space was a predictive factor for admission to the emergency department, the odds ratio between nursing home and patient’s home was 0.35, (IC95% [0.19; 0.64], p<0.007).The phone regulation characteristics (type of doctor, hour and day of the week) were not significantly associated with admission to the emergency department. Conclusion: Mobile GP unit is appropriate to fill a deficiency in after-hours care. It is particularly well suited to allow elderly patients to stay home. The study suggests promoting preventive measures precautions against falls and dyspneas in nursing homes, establishing protocols for expected deaths in nursing homes or home hospitalisation, and finally strengthening the information among young GP and among the public to ensure the continuity of the program.
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Master Thesis
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Submitted on : Thursday, June 7, 2018 - 11:58:49 AM
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Armelle Fiard. Médecin effecteur mobile : analyse descriptive des appels de 2015 au centre de réception et de régulation des appels du SAMU 22. Sciences du Vivant [q-bio]. 2017. ⟨dumas-01780768⟩



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