. Insee, Bilan démographique

K. E. Covinsky, R. M. Palmer, R. H. Fortinsky, S. R. Counsell, A. L. Stewart et al.,

, Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age, J Am Geriatr Soc. avr, vol.51, issue.4, pp.451-459, 2003.

, Personnes âgées dépendantes : les dépenses de prise en charge pourraient doubler en part de PIB d'ici 2060, DRESS

D. Sur,

J. Mccusker, F. Bellavance, S. Cardin, S. Trépanier, J. Verdon et al., Detection of older people at increased risk of adverse health outcomes after an emergency visit: the ISAR screening tool, J Am Geriatr Soc. oct, vol.47, issue.10, pp.1229-1266, 1999.

A. Sonnic, M. Pistorius, F. Delamarre-damier, L. D. Decker, B. Planchon et al., Validation of a screening tool toward a geriatric comprehensive assessment during a non geriatric consultation: the geriatric warning test, Gériatr Psychol Neuropsychiatr Viel. déc, issue.4, pp.429-435, 2011.

G. Cousins, Z. Bennett, G. Dillon, S. M. Smith, and R. Galvin, Adverse outcomes in older adults attending emergency department: systematic review and meta-analysis of the Triage Risk Stratification Tool, Eur J Emerg Med. août, vol.20, issue.4, pp.230-239, 2013.

C. E. Graf, S. V. Giannelli, F. R. Herrmann, F. P. Sarasin, J. Michel et al.,

, Identification of older patients at risk of unplanned readmission after discharge from the emergency department -comparison of two screening tools, Swiss Med Wkly, vol.141, p.13327, 2012.

R. Shaban, Theories of clinical judgment and decision-making : a review of the theoretical literature, JEPHC, vol.3, 2005.

E. Stolper, M. Van-de-wiel, P. Van-royen, M. Van-bokhoven, and T. Van-der-weijden,

G. J. Dinant, Gut Feelings as a Third Track in General Practitioners' Diagnostic Reasoning, J Gen Intern Med. févr, vol.26, issue.2, pp.197-203, 2011.

S. Katz, T. D. Downs, H. R. Cash, and R. C. Grotz, Progress in development of the index of ADL, The Gerontologist, vol.10, issue.1, pp.20-30, 1970.

M. P. Lawton and E. M. Brody, Assessment of older people: self-maintaining and instrumental activities of daily living, The Gerontologist, vol.9, issue.3, pp.179-86, 1969.

M. E. Charlson, P. Pompei, K. L. Ales, and C. R. Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis, vol.40, issue.5, pp.373-83, 1987.

M. F. Folstein, S. E. Folstein, and P. R. Mchugh, « Mini-mental state ». A practical method for grading the cognitive state of patients for the clinician, J Psychiatr Res, vol.12, issue.3, pp.189-98, 1975.

Y. Guigoz, B. Vellas, and P. J. Garry, Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation, Nutr Rev. janv, vol.54, issue.1, pp.59-65, 1996.

M. Deschodt, N. Wellens, T. Braes, D. Vuyst, A. Boonen et al., Prediction of functional decline in older hospitalized patients: a comparative multicenter study of three screening tools, Aging Clin Exp Res. déc, vol.23, issue.5-6, pp.421-427, 2011.

G. Cousins, Z. Bennett, G. Dillon, S. M. Smith, and R. Galvin, Adverse outcomes in older adults attending emergency department: systematic review and meta-analysis of the Triage Risk Stratification Tool, Eur J Emerg Med. août, vol.20, issue.4, pp.230-239, 2013.

W. D. Miller, K. Nguyen, S. Vangala, and E. Dowling, Clinicians can independently predict 30-day hospital readmissions as well as the LACE index, BMC Health Serv Res, vol.22

N. Allaudeen, J. L. Schnipper, E. J. Orav, R. M. Wachter, and A. R. Vidyarthi, Inability of providers to predict unplanned readmissions, J Gen Intern Med. juill, vol.26, issue.7, pp.771-777, 2011.

D. Kansagara, H. Englander, A. Salanitro, D. Kagen, C. Theobald et al.,

, Risk prediction models for hospital readmission: a systematic review, JAMA, vol.306, issue.15, pp.1688-98, 2011.

T. Traissac, M. Videau, M. Bourdil, I. Bourdel-marchasson, and N. Salles, The short mean length of stay of post-emergency geriatric units is associated with the rate of early readmission in frail elderly, Aging Clin Exp Res. juin, vol.23, issue.3, pp.217-239, 2011.

. Haute-autorité-de-santé, Comment réduire le risque de ré hospitalisations évitables des personnes âgées ?

C. Hyernard, A. Breining, S. Duc, D. Kobeh, M. Dubos et al., Atypical presentation of bacteremia in older patients is a risk factor for death, Am J Med. juin, p.0002934319304504, 2019.

H. Dickes-sotty, P. Chevalet, M. Fix, T. Riaudel, C. Serre-sahel et al.,

, Six-months outcomes after admission in acute geriatric care unit secondary to a fall

, Geriatr Psychol Neuropsychiatr Viel. déc, vol.10, issue.4, pp.391-401, 2012.

K. A. Mirkin, L. M. Enomoto, G. M. Caputo, and C. S. Hollenbeak, Risk factors for 30-day readmission in patients with congestive heart failure, Heart Lung J Crit Care, vol.46, issue.5, pp.357-62, 2017.

J. Gauthier, J. P. Kisterman, F. Chapalain, A. Texier, and P. Manckoundia, Réhospitalistion précoce des personnes âgées d'au moins 75 ans admises dans un service de médecine polyvalente post-urgence : taux et facteurs prédictifs, Rev Med Interne. août, vol.37, issue.8, pp.521-529, 2016.

P. Soubeyran, C. Terret, C. Bellera, F. Bonnetain, O. S. Jean et al., Role of geriatric intervention in the treatment of older patients with cancer: rationale and XVIII design of a phase III multicenter trial, BMC Cancer, vol.01, issue.1, p.932, 2016.

F. Yang, Y. Wang, C. Yang, M. H. Zhou, J. Shu et al., Improving clinical judgment by simulation: a randomized trial and validation of the Lasater clinical judgment rubric in Chinese, BMC Med Educ. 14 janv, vol.19, issue.1, p.20, 2019.

J. P. Kassirer, Teaching clinical reasoning: case-based and coached, Acad Med J Assoc Am Med Coll. juill, vol.85, issue.7, pp.1118-1142, 2010.

. Insee, Projection de la population pour la France métropolitaine à l'horizon 2050

D. Sur,

, Pyramide des âges en, 2019.

, Projections de population à l'horizon 2070

B. Ennuyer, A quel âge est-on vieux ?, Gerontol Soc, vol.34, issue.138, pp.127-169, 2011.

, Agence Technique de l'Information sur l'Hospitalisation

, Analyse de l'activité hospitalière 2017

D. Sur,

, Personnes âgées dépendantes : les dépenses de prise en charge pourraient doubler en part de PIB d'ici 2060

D. Sur,

J. Bouchon, 1+2+3 ou comment tenter d'être efficace en gériatrie, Rev Prat, issue.34, pp.888-92, 1984.

L. Z. Rubenstein, A. E. Stuck, A. L. Siu, and D. Wieland, Impacts of geriatric evaluation and management programs on defined outcomes: overview of the evidence, J Am Geriatr Soc. sept, vol.39, issue.9, 1991.

L. P. Fried, C. M. Tangen, J. Walston, A. B. Newman, C. Hirsch et al., Frailty in Older Adults: Evidence for a Phenotype, J Gerontol A Biol Sci Med Sci. 1 mars, vol.56, issue.3, pp.146-57, 2001.

G. Ellis, M. Gardner, A. Tsiachristas, P. Langhorne, O. Burke et al.,

, Comment réduire le risque de ré hospitalisations évitables des personnes âgées ?, Cochrane Database Syst Rev, vol.12, 2017.

T. Traissac, M. Videau, M. Bourdil, I. Bourdel-marchasson, and N. Salles, The short mean length of stay of post-emergency geriatric units is associated with the rate of early readmission in frail elderly, Aging Clin Exp Res. juin, vol.23, issue.3, pp.217-239, 2011.

I. Lanièce, P. Couturier, M. Dramé, G. Gavazzi, S. Lehman et al., Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units, Age Ageing. juill, vol.37, issue.4, pp.416-438, 2008.

C. Van-walraven, J. A. Forster, and A. J. , A meta-analysis of hospital 30-day avoidable readmission rates, J Eval Clin Pract. déc, vol.18, issue.6, pp.1211-1219, 2012.

J. Rumball-smith and P. Hider, The validity of readmission rate as a marker of the quality of hospital care, and a recommendation for its definition, N Z Med J. 13 févr, vol.122, pp.63-70, 1289.

P. Halfon, Y. Eggli, G. Van-melle, C. J. Wasserfallen, J. B. Burnand et al.,

, Measuring potentially avoidable hospital readmissions, J Clin Epidemiol. juin, vol.55, issue.6, pp.573-87, 2002.

, Loi publique 111-148. An act entitled The Patient Protection And Affordable Care Act, p.906

N. R. Desai, J. S. Ross, J. Y. Kwon, J. Herrin, K. Dharmarajan et al.,

, Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions, JAMA, vol.27, issue.24, pp.2647-56, 2016.

L. O. Hansen, R. S. Young, K. Hinami, A. Leung, and M. V. Williams, Interventions to reduce 30-day rehospitalization: a systematic review, Ann Intern Med, vol.155, issue.8, pp.520-528, 2011.

L. Z. Rubenstein, K. R. Josephson, G. D. Wieland, P. A. English, J. A. Sayre et al., Effectiveness of a geriatric evaluation unit. A randomized clinical trial, N Engl J Med. 27 déc, vol.311, issue.26, pp.1664-70, 1984.

D. Somme and C. Rousseau, L'évaluation gériatrique standardisée ou l'approche gérontologique globale : où en est-on ?, Rev Med Interne. févr, vol.34, issue.2, pp.114-136, 2013.

S. Katz, T. D. Downs, H. R. Cash, and R. C. Grotz, Progress in development of the index of 66

, ADL. The Gerontologist, vol.10, issue.1, pp.20-30, 1970.

M. P. Lawton and E. M. Brody, Assessment of older people: self-maintaining and instrumental activities of daily living, The Gerontologist, vol.9, issue.3, pp.179-86, 1969.

W. Spector, S. Katz, J. Murphy, and J. Fulton, The hierarchical relationship between activities of daily living and instrumental activities of daily living, J Chron Dis, vol.40, issue.6, pp.481-490, 1987.

M. F. Folstein, S. E. Folstein, and P. R. Mchugh, « Mini-mental state ». A practical method for grading the cognitive state of patients for the clinician, J Psychiatr Res, vol.12, issue.3, pp.189-98, 1975.

W. J. Burke, R. L. Nitcher, W. H. Roccaforte, and S. P. Wengel, A prospective evaluation of the Geriatric Depression Scale in an outpatient geriatric assessment center, J Am Geriatr Soc. déc, vol.40, issue.12, pp.1227-1257, 1992.

B. Vellas, Y. Guigoz, P. J. Garry, F. Nourhashemi, D. Bennahum et al.,

, Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients, Nutrition. févr, vol.15, issue.2, pp.116-138, 1999.

Y. Guigoz, B. Vellas, and P. J. Garry, Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation, Nutr Rev. janv, vol.54, issue.1, pp.59-65, 1996.

C. E. Roffman, J. Buchanan, and G. T. Allison, Charlson Comorbidities Index, J Physiother. juill, vol.62, issue.3, p.171, 2016.

M. E. Charlson, P. Pompei, K. L. Ales, and C. R. Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis, vol.40, issue.5, pp.373-83, 1987.

J. Almirall and M. Fortin, The coexistence of terms to describe the presence of multiple concurrent diseases, J Comorb, vol.3, pp.4-9, 2013.

. Hcaam, cité 12/04/2019. Personnes âgées, état de santé et dépendance : quelques statistiques

D. Sur,

T. N. Nguyen, P. Ngangue, T. Bouhali, B. L. Ryan, M. Stewart et al., Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis, Int J Environ Res Public Health. 8 avr, vol.16, issue.7, 2019.

C. E. Graf, D. Zekry, S. Giannelli, J. Michel, and T. Chevalley, Efficiency and applicability 67 of comprehensive geriatric assessment in the emergency department: a systematic review, Aging Clin Exp Res. août, vol.23, issue.4, pp.244-54, 2011.

G. A. Caplan, A. J. Williams, B. Daly, and K. Abraham, A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department--the DEED II study, J Am Geriatr Soc. sept, vol.52, issue.9, pp.1417-1440, 2004.

A. Sonnic, M. Pistorius, F. Delamarre-damier, L. D. Decker, B. Planchon et al., Validation of a screening tool toward a geriatric comprehensive assessment during a non geriatric consultation: the geriatric warning test, Geriatr Psychol Neuropsychiatr Viel. déc, issue.4, pp.429-435, 2011.

J. Mccusker, F. Bellavance, S. Cardin, S. Trépanier, J. Verdon et al., Detection of older people at increased risk of adverse health outcomes after an emergency visit: the ISAR screening tool, J Am Geriatr Soc. oct, vol.47, issue.10, pp.1229-1266, 1999.

J. Mccusker, F. Bellavance, S. Cardin, E. Belzile, and J. Verdon, Prediction of hospital utilization among elderly patients during the 6 months after an emergency department visit, Ann Emerg Med. nov, vol.36, issue.5, pp.438-483, 2000.

L. C. Mion, R. M. Palmer, G. J. Anetzberger, and S. W. Meldon, Establishing a case-finding and referral system for at-risk older individuals in the emergency department setting: the SIGNET model, J Am Geriatr Soc, vol.49, issue.10, pp.1379-86, 2001.

S. W. Meldon, L. C. Mion, R. M. Palmer, B. L. Drew, J. T. Connor et al., A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department, Acad Emerg Med. mars, vol.10, issue.3, pp.224-256, 2003.

G. Cousins, Z. Bennett, G. Dillon, S. M. Smith, and R. Galvin, Adverse outcomes in older adults attending emergency department: systematic review and meta-analysis of the Triage Risk Stratification Tool, Eur J Emerg Med. août, vol.20, issue.4, pp.230-239, 2013.

C. E. Graf, S. V. Giannelli, F. R. Herrmann, F. P. Sarasin, J. Michel et al.,

, Identification of older patients at risk of unplanned readmission after discharge from the emergency department -comparison of two screening tools, Swiss Med Wkly, vol.141, p.13327, 2012.

C. Van-walraven, I. A. Dhalla, C. Bell, E. Etchells, I. G. Stiell et al., Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community, Can Med Assoc J. 6 avr, vol.182, issue.6, pp.551-558, 2010.

P. E. Cotter, V. K. Bhalla, S. J. Wallis, and R. Biram, Predicting readmissions: poor performance of the LACE index in an older UK population, Age Ageing, vol.41, issue.6, pp.784-793, 2012.

J. Gauthier, J. P. Kisterman, F. Chapalain, A. Texier, and P. Manckoundia, Ré hospitalisation précoce des personnes âgées d'au moins 75 ans admises dans un service de médecine polyvalente post-urgence : taux et facteurs prédictifs, Rev Med Interne. août, vol.37, issue.8, pp.521-529, 2016.

E. Logue, W. Smucker, and C. Regan, Admission Data Predict High Hospital Readmission Risk, J Am Board Fam Med. févr, vol.29, issue.1, pp.50-59, 2016.

A. Morandi, G. Bellelli, E. E. Vasilevskis, R. Turco, F. Guerini et al.,

, Predictors of rehospitalization among elderly patients admitted to a rehabilitation hospital: the role of polypharmacy, functional status, and length of stay, J Am Med Dir Assoc, vol.14, issue.10, pp.761-768, 2013.

M. D. Silverstein, H. Qin, S. Q. Mercer, J. Fong, and Z. Haydar, Risk factors for 30-day hospital readmission in patients ?65 years of age, Proc Bayl Univ Med Cent, vol.21, issue.4, pp.363-72, 2008.

K. A. Mirkin, L. M. Enomoto, G. M. Caputo, and C. S. Hollenbeak, Risk factors for 30-day readmission in patients with congestive heart failure, Heart Lung J Crit Care, vol.46, issue.5, pp.357-62, 2017.

B. Neupane, S. D. Walter, P. Krueger, T. Marrie, and M. Loeb, Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study, BMC Geriatr. 11 mai, vol.10, p.22, 2010.

L. M. Enomoto, D. P. Shrestha, M. B. Rosenthal, C. S. Hollenbeak, and R. A. Gabbay, Risk factors associated with 30-day readmission and length of stay in patients with type 2 diabetes, J Diabetes Complications, vol.31, issue.1, pp.122-129, 2017.

S. E. Campbell, D. G. Seymour, W. R. Primrose, and . Project, A systematic literature review of factors affecting outcome in older medical patients admitted to hospital, Age Ageing. mars, vol.33, issue.2, pp.110-115, 2004.

H. Dickes-sotty, P. Chevalet, M. Fix, T. Riaudel, C. Serre-sahel et al., Six-months outcomes after admission in acute geriatric care unit secondary to a fall

, Prévenir la dépendance iatrogène liée à, vol.10, 2012.

, l'hospitalisation chez les personnes âgées

S. Merino-martín and C. Aj, Impact of hospital admission on functional and cognitive measures in older subjects, Eur Geriatr Med. août, vol.3, issue.4, pp.208-220, 2012.

K. E. Covinsky, R. M. Palmer, R. H. Fortinsky, S. R. Counsell, A. L. Stewart et al.,

, Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age, J Am Geriatr Soc. avr, vol.51, issue.4, pp.451-459, 2003.

R. H. Fortinsky, K. E. Covinsky, R. M. Palmer, and C. S. Landefeld, Effects of functional status changes before and during hospitalization on nursing home admission of older adults, J Gerontol A Biol Sci Med Sci, vol.54, issue.10, pp.521-526, 1999.

H. M. Krumholz, Post-Hospital Syndrome -An Acquired, Transient Condition of Generalized Risk, N Engl J Med. 10 janv, vol.368, issue.2, pp.100-102, 2013.

S. Mazière, I. Lanièce, N. Hadri, C. Bioteau, C. Millet et al., Facteurs prédictifs du déclin fonctionnel de la personne âgée après une hospitalisation en court séjour gériatrique : importance de l'évolution fonctionnelle récente, Press Med. févr, vol.40, issue.2, pp.101-111, 2011.

E. P. Blakey, D. Jackson, H. Walthall, and H. Aveyard, What is the experience of being readmitted to hospital for people 65 years and over? A review of the literature, Contemp Nurse. déc, vol.53, issue.6, pp.698-712, 2017.

J. Pierron, Les trois sens du sens clinique, Ethique Sante. mars, vol.11, issue.1, pp.38-43, 2014.

E. Giroux and . Qu, entendre par 'sens clinique' à l'heure de l'Evidence-Based Medicine et de la Patient-Based Medicine ?, Ethique Sante. mars, vol.11, issue.1, pp.1151-1159, 2010.
URL : https://hal.archives-ouvertes.fr/hal-01998839

P. Hallouët, Jugement clinique

R. Shaban, Theories of clinical judgment and decision-making : a review of the theoretical literature, JEPHC, vol.3, 2005.

T. Greenhalgh, Intuition and evidence--uneasy bedfellows?, Br J Gen Pract J R Coll Gen Pract. mai, vol.52, issue.478, pp.395-400, 2002.

L. King and J. Appleton, Intuition : a critical review of the reserach and rhetoric, J Adv Nurs, vol.26, pp.194-202, 1997.

G. Karthikeyan and P. Pais, Clinical judgement & evidence-based medicine: time for reconciliation, Indian J Med Res, vol.132, pp.623-629, 2010.

C. Melin-johansson, R. Palmqvist, and L. Rönnberg, Clinical intuition in the nursing process and decision-making-A mixed-studies review, J Clin Nurs. déc, vol.26, pp.3936-3985, 2017.

E. Stolper, M. Van-de-wiel, P. Van-royen, M. Van-bokhoven, and T. Van-der-weijden,

G. J. Dinant, Gut Feelings as a Third Track in General Practitioners' Diagnostic Reasoning, J Gen Intern Med. févr, vol.26, issue.2, pp.197-203, 2011.

E. Stolper, M. Van-bokhoven, P. Houben, P. Van-royen, M. Van-de-wiel et al.,

T. Weijden, The diagnostic role of gut feelings in general practice. A focus group study of the concept and its determinants, BMC Fam Pract. 18 févr, vol.10, p.17, 2009.

E. Stolper, J. Legemaate, and G. J. Dinant, How do disciplinary tribunals evaluate the « gut feelings » of doctors? An analysis of Dutch tribunal decisions, J Law Med. sept, vol.18, issue.1, pp.68-75, 2000.

F. Yang, Y. Wang, C. Yang, M. H. Zhou, J. Shu et al., Improving clinical judgment by simulation: a randomized trial and validation of the Lasater clinical judgment rubric in Chinese, BMC Med Educ. 14 janv, vol.19, issue.1, p.20, 2019.

A. G. , Teaching Clinical Judgment : a review with Consideration of Applications for Health Professions, The Open Nutr, vol.9, pp.53-64, 2015.

J. P. Kassirer, Teaching clinical reasoning: case-based and coached, Acad Med. juill, vol.85, issue.7, pp.1118-1142, 2010.

S. Legrain, F. Tubach, D. Bonnet-zamponi, A. Lemaire, J. Aquino et al.,

, A New Multimodal Geriatric Discharge-Planning Intervention to Prevent Emergency Visits and Rehospitalizations of Older Adults: The Optimization of Medication in AGEd Multicenter Randomized Controlled Trial, J Am Geriatr Soc, vol.59, issue.11, pp.2017-2045, 2007.

. Recopier-le-dessin,