The time it takes for patients to be readmitted to hospital is a major public health issue, both in terms of medical time and costs.
In fact, 15% of patients of all ages are likely to be re-hospitalized within a month of hospitalization.
Today, hospitalizations present a significant nosocomial risk, all the more so in fragile populations. If these hospitalizations are long or repeated, it is crucial to develop solutions to reduce their number.
Elderly people often have a number of complementary pathologies and frailties, which are frequently destabilized during hospitalization or on discharge.
In this context of medico-social and financial stakes, a 2012 survey showed that 86% of French physicians would be prepared to make themselves available within 24-48 hours of hospital discharge if the situation justified it. Changes in medical demographics are forcing primary care physicians to adapt their practices, and the evidence of a reduced risk of re-hospitalization would make it possible to prioritize the provision of this consultation on discharge from hospital.
Post-hospitalization follow-up consultations with the primary care physician are recommended, but investigators have very little data on their benefits.
Investigators hypothesise that an early consultation (1 month post-hospitalization at most) by an elderly patient's primary care physician after hospitalization in geriatric medicine promotes: patient follow-up; reduced risk of re-hospitalization within 3 months.
The aim of this study is to determine the association of an early consultation by the primary care physician in the month following discharge from geriatric medicine hospitalization with rehospitalization rates within 3 months.
Age ≥ 75 years
Patients hospitalized in the geriatric department of one of the investigating centers
Patient discharged home from the geriatrics department of one of the investigating centers
No objection from patient or legal representative to participate in study
Patients who do not have a primary care physician
Patients living in an institution or transferred to an institution
Patients aged ≥ 75 years, who were hospitalized in the geriatrics department of one of the 3 investigating centers
Cohort
Prospective
Not listed
Describe the impact of early consultation by the primary care physician in elderly patients who have been hospitalized in geriatric medicine. The early consultation must have taken place within one month of discharge.
Rate of rehospitalization between initial hospital discharge and 3-month follow-up. This rehospitalization rate will be compared between the 2 groups (with and no consultation). At 1 month : date of consultation with the primary care physician, Number of unscheduled rehospitalizations.
Describe the impact of early consultation by the primary care physician in elderly patients who have been hospitalized in geriatric medicine. The early consultation must have taken place within one month of discharge.
Rate of rehospitalization between initial hospital discharge and 3-month follow-up. This rehospitalization rate will be compared between the 2 groups (with and no consultation). At 3 months : date of consultation with the primary care physician, Number of unscheduled rehospitalizations.
Demonstrate reduction in 1-month mortality
1-month mortality
Demonstrate reduction in 3-month mortality
3-month mortality
Demonstrate reduction in length of stay in hospital
Number of days of unscheduled full hospitalization between discharge from 1st hospitalization and 3-month visit,
Demonstrate reduced care costs
Total cost of all care procedures between initial hospital admission and 3-month visit
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