The World Health Organization supports collaborative practice in primary care, defining it as "when multiple health professionals from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care across settings" (1). Previous research have shown that collaborative practice in primary care improves care pathways, efficiency of care (2,3), job satisfaction among health professionals (4-6), and economic efficiency (3,7). Riverin et al. found a reduction in post-hospitalization mortality with collaborative practice (8).

In France, the establishment of primary care teams following the American model of Centered Medical Homes is encouraged. In the Pays de la Loire region, two models exist: A national and a regional model.

A major issue for patient care team is the care of seniors (9,10).Hospitalizations can have adverse health effects for this population (11,12). 45% of emergency admissions follow by a hospitalization concern them (13).

The hypothesis of the study is that collaborative practice could reduce the global rate of potential avoidable hospitalizations among seniors.

Inclusion Criteria:

• Patients over 75 years old and over 65 years old with chronic disease(s), with a general practitioner in Pays de la Loire, affiliated with the general health insurance system and have had at least one healthcare encounter, and residing in the Pays de la Loire region.

Exclusion Criteria:

• Patients whose general practitioner has ceased their practice or changed their affiliation, as well as patients who have switched to a new general practitioner.

Seniors