Devenir des patients ayant bénéficié d'un conseil médical au SAMU 14 en journée sans déploiement de moyen

Abstract : The objective was to know if the medical regulation (MR) ensured by the 15, enabled to better guide the patients, by consuming less care without degrading the medical care. We conducted a descriptive monocentric epidemiological study by a telephone survey. 227 patients were recalled 14 to 21 days after their initial call (week of the 14th to the 19th of May 2018 in Calvados), if they benefited during the day of a MR with simple advice or referral to a general practitioner (GP), without sending any means or directing to the emergency room (ER). 58% (n=131) of recontacted patients were able to assess symptoms evolution, 80% reported it was favorable, 14% stable, 6% unfavorable. Of these, 75% (n=6) had been to the ER, 87.5% (n=7) were satisfied with the call. 21% (n=27) of patients had been to the ER and 73% (n = 72) had seen a doctor before: they were more hospitalized when a doctor referred them to the ER (64% vs 6%, p = 0.002). After 5pm, calls were more related to the closing of the GP’s practice (21% vs. 7%, p = 0.02) and the MR's decision directed less towards a GP (65% vs. 51%, p = 0.04). Where the supply of care is low, the unavailability of the GP was a more frequent reason for calling (32% vs. 17%, p = 0.049). Patients from areas without unscheduled care centers were less likely to be referred to a GP (38% vs 52%, p = 0.03), and would have gone more frequently to. the ER without a MR (52% vs 28%), p = 0.01). The MR seems to direct the patient towards the adapted care without being harmful. The increasing demand of the 15 related to medical demography’s problems could compromise its availability. The offer of unscheduled care would benefit from being developed.
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Master Thesis
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Bastien Julliard. Devenir des patients ayant bénéficié d'un conseil médical au SAMU 14 en journée sans déploiement de moyen. Médecine humaine et pathologie. 2018. ⟨dumas-02050727⟩

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