Decrease in hospitalisations via calls received to geriatric hotlines: French multicentre prospective study on people aged 75 years over (Preprint)

Abstract

In France, for general practitioners (GP), the Emergency Department (EDs) is the quickest and most common way to respond to the complexity of caring for elderly patients with multiple conditions. The study shows that the pathway through the EDs would sometimes have deleterious effects on the health of older adults. In 2013, France’s regional health authorities offered to implement telephone hotlines in order to promote GP clinic-hospital interactions.

The main objective of the study was to analyse if telephone hotlines enable fewer hospital admissions and, especially EDs passage, through the solutions provided by the responding physicians.

It is an observational, multicentre, and descriptive study conducted from April 2018 to April 2020 at seven French investigation sites. The telephone hotline physicians filled two questionnaires: the first one while receiving a call, and the second one when a patient arrived in the geriatric short-stay department after having been referred via the hotline. In this study, our interest will be on the first questionnaire

The study population concerned by the phone call questionnaire gathered 4 137 individuals who fulfilled the inclusion and exclusion criteria. Among the 4 137 phone calls received, 64.2% (n=2 657) were for advice and 35.8% (n=1 480) for emergency hospitalization. Among the 1 480 phone calls for emergency hospitalization, 285 calls ended up in hospital admission in the emergency room (19.3%), and 658 calls in the geriatric short stay (44.5%). Among the 2 657 calls for advice/consultation/delayed hospitalization, 9.7% were also answered by emergency hospital admission.

This study shows the value of hotlines in guiding the care of older adults. The results show the effectiveness of hotlines in avoiding unnecessary hospital admissions or in identifying cases requiring hospital admission in the emergency room. Hotlines can help improve the care pathway for older adults and pave the way for future progress, such as new patient care modalities, the development of more appropriate responses for this population, and the drop of inappropriate emergency room visits.

Registered under Clinical Trial Number NCT03959475. This study was approved and peer-reviewed by the committee for the protection of persons of Sud Est V of Grenoble University Hospital Center (registered under 18-CETA-01 No.ID RCB 2018-A00609-46).

RR2-10.2196/15423