[Is it still appropriate to transfer residents of nursing homes in the 16th arrondissement of Paris to emergency?].
Geriatrie et psychologie neuropsychiatrie du vieillissement · 2025-03-01 · Observational study
Abstract
In January 2023, 14.5 millions people were over 65 (21.3%) and 600,000 people live in nursing homes. A 2018 study showed that 30 % of visits to the emergency room were "avoidable". Measure 5 of the 2019-2022 emergency overhaul pact is to generalize routes dedicated to the elderly to avoid recourse to emergencies. The EMGE (Mobile Extra-Hospital Geriatrics Team) is a key mechanism in coordination between nursing homes and emergency reception services. Objective: Study the reasons why elderly people residing in nursing home go to emergency. We prospectively identified and described emergency transfers of residents of 4 nursing homes, from January 1 to March 31, 2022. Then, retrospectively, we requested a panel of 9 expert in order to judge if the transfer to the emergency was appropriate, based on a questionnaire. 50 (75,6%) transfer were assessed as suitable by at least 5 of the 9 experts. The average age of transferred residents was 91.7±6.4 years. In 35 % of cases, the symptoms motivating the transfer had been present for more than 48 hours. The main reason for 2 transfers was a fall (35%). A nurse was at the origin of 40 transfers (61%). This study shows that 76% of visits to the emergency room were considered suitable. The management of emergency situations in nursing homes is a real public health issue, and the pivotal role of a GMT is to secure, optimize and streamline the care of elderly people in nursing homes, and to limit as much as possible the transfer to emergencies.