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Master Thesis

Impact du contact médical préalable sur le parcours de soins des patients consultant aux urgences de Bordeaux Métropole

Abstract : Objectives: we wish to compare the care pathway between patients with prior medical contact and patients consulting directly in the emergency department. We studied the rate of hospitalization between these two populations.Method: this is a multicentric transverse study carried out in 9 emergency departments in the Gironde region over 2 24-hour periods. It included all patients over 18 years of age presenting in an emergency department. The main composite assessment criterion was prior medical contact defined by a consultation with the attending physician, a doctor on duty or specialist, or a call to the SAMU. A questionnaire was used to establish patient profiles and describe their care pathway in the emergency department up to the time of their arrival. Results: of the 1165 patients included in the study, 636 or 54.6% had prior medical contact before consulting the emergency department, compared with 529 or 45.4% who consulted spontaneously. A majority (79.7%) of the patients who spontaneously consulted the emergency department had acute symptoms (less than 24 hours), in contrast to the patients in the group who had prior medical contact, most of whom had symptoms lasting more than 24 hours (55.1%). Patients who had had prior medical contact were more likely to use emergency department care, except for x-rays (25.6% vs. 37.4%). Finally, patients with prior medical contact had a higher rate of hospitalization than patients who visited the ED spontaneously (19.3% vs. 9%).Conclusion: in our study, patients who had prior medical contact prior to admission to the emergency department had symptoms that lasted longer, received more complementary examinations, and were hospitalized more often. The creation of a triage system dedicated to patients referred by their doctor could improve their care and optimize the flow to the emergency department.
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Master Thesis
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Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, June 12, 2020 - 4:29:53 PM
Last modification on : Saturday, June 20, 2020 - 3:14:47 AM


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David Templier. Impact du contact médical préalable sur le parcours de soins des patients consultant aux urgences de Bordeaux Métropole. Médecine humaine et pathologie. 2020. ⟨dumas-02866674⟩



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