Provision of a Mobile Geriatric Team Extra-Community Hospital

Study Overview
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Brief Summary
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The purpose of this study is to demonstrate the effectiveness of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month. The primary endpoint: survival without hospitalization through the emergency inappropriate to 1 month.

Detailed Description
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The purpose of this study is to assess the effectiveness of the Mobile Geriatrics on the management of complex situations in retirement homes and in ambulatory care of frail elderly patients, reported by the generalist doctor, in terms of improving the conditions of use technical support hospital follow-up recommendations given by the mobile team and their impact on outcomes of care.

Official Title
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Provision of a Mobile Geriatric Team Extra-Community Hospital in Assessing and Regulating the Hospitalization of Frail Elderly Patients With Complex Medical and Social Situation

Conditions
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Geriatric Disorder, Mobil Unit

Intervention / Treatment
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* Other: home visit
* Other: telephone management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient aged 75 and over living in complex medical or psycho-social complex or at risk of hospitalization Patient affiliated to social security or beneficiary of such a regime Patient available for follow-up to 6 months with a caregiver or accompanying social duly appointed. Exclusion Criteria: Patient residing outside intervention sector Life-threatening emergency (ambulance) Lack of complexity of the situation, supported by routine care

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| home visit of UMG<br>home visit with evaluation and management of the situation (control over in-home telephone) | Other: home visit<br>* home visit of UMG<br>|
| telephone management<br>geriatric mobile unit provides a telephone advice only to the general practitioner with guidance and recommendations (call control) | Other: telephone management<br>* telephone management of the situation reported by the patient's GP<br>* Other names: telephone management of the mobile unit of Geriatrics;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| effectiveness of the visit of the mobile unit to reduce the geriatric hospital inappropriate (especially for emergencies) to 1 month | inappropriate survival without hospitalization through the emergency room at 1 month | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| follow-up rate of the proposals of UMG ext (adherence to recommendations and feasibility) and analyze the reasons for not monitoring these proposals one month | follow-up of recommendations made by the mobile unit of Geriatrics | 1 month | 
| survival without hospitalization inappropriate, mortality, changes in functional status and cognitive health care consumption up to 6 months of surgery | Unplanned hospitalization rates obtained by telephone follow-up at 3 and 6 months | 6 months | 
| effectiveness of the visit of the mobile geriatric home versus telephone follow-up of mobile geriatric unit | Analysis of sub-groups | 6 months | 
| needs and difficulties of attending physicians in the care of frail elderly patients with complex medical and social situation before and after the establishment of mobile units for geriatrics. | Questionnaire to GPs in the health sector concerned | 1 year | 
| cost effectiveness of two types of visit of the mobile unit of Geriatrics (telephone regulation and control over travel home phone) | Cost of hospitalization. | 6 months |