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Master Thesis

Analyse des admissions non justifiées de résidents des EHPAD de Dordogne dans la structure d’Urgence du Centre Hospitalier de Périgueux

Abstract : With a population of 6 million people, the over 75s represented 9.3% of the French population in 2019 (INSEE 2019). Their growth, result of lower fertility and increased life expectancy, is significant. Many EHPAD residents are fragile and suffer from multiple chronic illnesses. When these residents experience an acute exacerbation or complication of their chronic illness, injury (related to a fall) or acute infection, they require medical attention and are very often referred to the emergency room. Their visit to the emergency room undoubtedly induces harmful consequences for them. As a reference hospital in Dordogne and due to the average age of the population above the national average, the emergency structure of the Périgueux Hospital Center is required to treat a large number of EHPAD residents and this reflection led us to ask ourselves what was the proportion of unjustified EHPAD residents admissions in the emergency structure of the Périgueux hospital center. The main objective was to identify the proportion of emergency visits, justified or not, and the secondary objectives were to assess the intrinsic factors linked to a higher unjustified consultation rate. of these patients. We have chosen to answer this question by carrying out a mono-centric retrospective cross-sectional epidemiological study from October 1, 2019 to December 31, 2019 in the emergency rooms of the Périgueux hospital center. The primary endpoint was defined by two different operators, emergency doctors, with good experience and good knowledge of the department. We were able to identify that 23.3% of admissions were deemed unjustified by our assessors. The study population was elderly (median 89 years), very dependent (65% GIR 1 or 2), and rather female (76% of them). Patients whose admission was deemed justified had higher IAO triage levels according to the French CIMU and consulted mainly for trauma, dyspnea or acute abdominal syndrome. The level of medicalization of the EHPAD did not seem to have an influence on the criterion justified or not of the admissions.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03192217
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, April 7, 2021 - 7:00:23 PM
Last modification on : Thursday, May 13, 2021 - 3:18:15 AM

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Clara Colin. Analyse des admissions non justifiées de résidents des EHPAD de Dordogne dans la structure d’Urgence du Centre Hospitalier de Périgueux. Médecine humaine et pathologie. 2021. ⟨dumas-03192217⟩

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