This single-center, prospective, observational cohort study aims to evaluate the actual implementation rate of social recommendations formulated by the Mobile Geriatric Team at Saint-Étienne University Hospital three months after hospital discharge. These recommendations may include human assistance, technical aids, financial aid applications, legal protective measures, or referrals to appropriate care structures.
A structured telephone interview at three months will assess the degree of implementation, explore associated barriers (administrative, cognitive, organizational, ...), and investigate any potential link with hospital readmissions or changes in patients' living situations.
Patients aged 75 years or older
Patients assessed by the Mobile Geriatric Team of the Saint-Etienne University Hospital with the formulation of social recommendations
Patients residing at home or in a long-term care facility for dependent elderly individuals (nursing home / EHPAD)
Informed consent obtained from the patient or their legal representative
Patients under 75 years old
Refusal to participate in the study by the patient (or by the legally authorized representative/trusted person).
Patients receiving exclusive palliative care
Inability to ensure follow-up: in case of non-response at three months or in the event of death
Any patient who has benefited from an assessment by the CHUSE EMG with formulation of social recommendations between August 1, 2025 and January 31, 2026 will be included.
Cohort
Prospective
Telephone interview
Other interventionA structured telephone interview at three months will assess the degree of implementation, explore associated barriers (administrative, cognitive, organizational, ...), and investigate any potential link with hospital readmissions or changes in patients' living situations.
Rate of implementation of social recommendations
Evaluate the three-month implementation rate of the total social recommendations issued by the mobile geriatric team.
Factors hindering the implementation of recommendations
Identify the factors holding back the implementation of TOTAL recommendations (then SPECIFIC: human, technical, financial, patient orientation, implementation of legal protection measures).
Reasons for refusal or non-implementation
Analyze the reasons for refusal or non-implementation.
Impact of non-implementation on the re-hospitalization rate
Evaluate the impact of non-implementation on the re-hospitalization rate.
Patient's living environment
Document changes in the patient's living environment at three months.
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