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The purpose of this study is to demonstrate the effectiveness of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month.
The primary endpoint: survival without hospitalization through the emergency inappropriate to 1 month.
The purpose of this study is to assess the effectiveness of the Mobile Geriatrics on the management of complex situations in retirement homes and in ambulatory care of frail elderly patients, reported by the generalist doctor, in terms of improving the conditions of use technical support hospital follow-up recommendations given by the mobile team and their impact on outcomes of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| home visit of UMG | home visit with evaluation and management of the situation (control over in-home telephone) |
| |
| telephone management | geriatric mobile unit provides a telephone advice only to the general practitioner with guidance and recommendations (call control) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| home visit | Other | home visit of UMG |
| |
| telephone management |
| Measure | Description | Time Frame |
|---|---|---|
| effectiveness of the visit of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month | inappropriate survival without hospitalization through the emergency room at 1 month | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| follow-up rate of the proposals of UMG ext (adherence to recommendations and feasibility) and analyze the reasons for not monitoring these proposals one month | follow-up of recommendations made by the mobile unit of Geriatrics | 1 month |
| survival without hospitalization inappropriate, mortality, changes in functional status and cognitive health care consumption up to 6 months of surgery |
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Inclusion Criteria:
Exclusion Criteria:
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The study population includes patients over 75 years in medical condition or psycho-social complex, followed by a general practitioner to population centers include: Grenoble, Annecy and Roanne.
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| Name | Affiliation | Role |
|---|---|---|
| Pascal COUTURIER, PUPH | Geriatric unit - University Hospital of Grenoble | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CH Annecy | Annecy | 74000 | France | |||
| University Hospital of Grenoble |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9563983 | Background | Bernabei R, Landi F, Gambassi G, Sgadari A, Zuccala G, Mor V, Rubenstein LZ, Carbonin P. Randomised trial of impact of model of integrated care and case management for older people living in the community. BMJ. 1998 May 2;316(7141):1348-51. doi: 10.1136/bmj.316.7141.1348. | |
| 8105269 | Background | Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993 Oct 23;342(8878):1032-6. doi: 10.1016/0140-6736(93)92884-v. |
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| ID | Term |
|---|---|
| D006792 | House Calls |
| ID | Term |
|---|---|
| D011364 | Professional Practice |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| Other |
telephone management of the situation reported by the patient's GP |
|
|
Unplanned hospitalization rates obtained by telephone follow-up at 3 and 6 months |
| 6 months |
| effectiveness of the visit of the mobile geriatric home versus telephone follow-up of mobile geriatric unit | Analysis of sub-groups | 6 months |
| needs and difficulties of attending physicians in the care of frail elderly patients with complex medical and social situation before and after the establishment of mobile units for geriatrics. | Questionnaire to GPs in the health sector concerned | 1 year |
| cost effectiveness of two types of visit of the mobile unit of Geriatrics (telephone regulation and control over travel home phone) | Cost of hospitalization. | 6 months |
| Grenoble |
| 38000 |
| France |
| CH Roanne | Roanne | 42300 | France |
| 11576978 | Background | Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, Williams D, Brummell K. Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ. 2001 Sep 29;323(7315):719-25. doi: 10.1136/bmj.323.7315.719. |