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Factors Predisposing to Inappropriate Transfers of Nursing Home Residents to Emergency Departments

NCT02677272 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 1040

Last updated 2024-02-23

No results posted yet for this study

Summary

According to the data of our nursing homes (NH) research network (REHPA - Gérontopôle Toulouse, 345 nursing home in France), 13.5% of NH residents are hospitalized every 3 months or about 50% per year. These hospitalizations concern for half, transfers to emergency department (ED). Data from the literature and the PLEIAD study, conducted with 300 NH in France, confirm that intense flows between NH and ED. These studies also support the idea that these transfers to ED potentially expose some NH residents to iatrogenic complications, a risk of functional decline, an increased risk of mortality, and generate additional health costs. To transfer to ED residents who will benefit from emergency care and not to transfer to ED residents for whom this transfer generates a higher risk than the expected benefit is the goal to reach to guarantee the better quality of care for NH residents.

Inappropriate transfer to ED may be defined by the absence of somatic emergency and / or palliative care known before transferring to ED and / or the presence of advance directives of non-hospitalization in the resident's file. This is a clinical situation that could be managed by other means that the transfer to ED without loss of opportunity for the patient.

The primary objective of our study is to determine the factors predisposing NH residents to inappropriate transfer to ED.

Our hypothesis is that inappropriate transfers to the ED of NH residents are conditioned by factors accessible to interventions such as the organization of the NH care system or by improving the management of some diseases in NH. Investigators also hypothesize that the cost of inappropriate transfers to the ED is considerable. Acknowledgement of costs generated by inappropriate transfers to ED would allow policy makers to make strategic decisions to improve care system.

Conditions

  • Frail Elderly

Interventions

OTHER

Appropriateness of NH resident's transfer to ED

Sponsors & Collaborators

  • Agence Régionale de la Santé - Midi Pyrénées

    collaborator OTHER_GOV

  • Ministry of Health, France

    collaborator OTHER_GOV

  • University Hospital, Toulouse

    lead OTHER

Principal Investigators

  • Yves ROLLAND, MD PhD · University Hospital, Toulouse

Eligibility

Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2016-01-01
Primary Completion
2018-07-31
Completion
2018-07-31

Countries

  • France

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT02677272 on ClinicalTrials.gov