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Réhospitalisation à trente jours et consultation précoce chez le médecin traitant : étude épidémiologique descriptive monocentrique
Mémoire de Master / Thèse d'exercice   Open Access

Réhospitalisation à trente jours et consultation précoce chez le médecin traitant : étude épidémiologique descriptive monocentrique

Chloé Silighini
Masters , Université de Montpellier
20/02/2020

Résumé

Early rehospitalization 30-day readmission rate Early consultation Treating physician Readmission Hospital discharge Réhospitalisation précoce Taux de réhospitalisation à trente jours Consultation précoce Médecin traitant Réadmission Sortie d’hospitalisation Risk factors Facteurs de risque
Early unplanned readmission, occurring within 30 days of discharge from hospital, represents a public health problem from an economic and medical point of view. In order to reduce these stays, the continuity of care during the transition between hospital and home must be improved, in particular through early consultation with the primary care physician within 7 days of discharge.Methods: this was a retrospective observational descriptive study on patients rehospitalised within thirty days of discharge from the UDOR of the Perpignan hospital. The objectives were to find out whether they had consulted their treating physician at an early stage and to study their risk factors for readmission.Results: in total, 34 patients were included out of the 157 rehospitalised over one year of the study, i.e. 21.7%. They were vulnerable (50%), polypathological (70.6%), polymedicated (73.5%) and socially isolated (32.3%). Women were in the majority (58.8%), the mean age was 76.5 years. On average, patients were readmitted to hospital 12.8 days [+/-9 days] after discharge, after an initial stay of 6.1 days [+/-3.3]. 67.6% (23) of the patients included had not consulted their primary care physician early (62%). The latter were readmitted to hospital in 48% of cases for an unstabilised pathology with an average length of stay of 6.6 days. They were significantly different from the other patients regarding polypathology and cardiac causes of hospital admission. Patients who consulted early (32.4% or 11 patients) were readmitted to hospital in 46% of cases for the relapse of a chronic pathology.Conclusion: more than two thirds of patients readmitted to hospital within 30 days had not consulted their general practitioner within 7 days, even though the protective effect of such a visit has been proven. From now on, at the exit of the UDOR, early consultation could be systematically planned and a prospective study on the rate of rehospitalisation could be carried out to measure the impact of such a visit in this population.

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