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Effectiveness and Organizational Conditions of Effectiveness of Telemedicine in Establishments Providing Care for the Dependent Elderly

Completed
Conditions
Health Services for the Aged
Interventions
Procedure: Evaluation of disease and follow-up
Registration Number
NCT03486977
Lead Sponsor
University Hospital, Bordeaux
Brief Summary

Study of interest of Telemedicine in establishments providing care for the dependent elderly (EHPAD in french) is a strategy for improving the course of care of residents, including the number not programmed hospitalizations, and a multidimensional analysis of the conditions of effectiveness of telemedicine will identify the keys to optimize its use.

Detailed Description

The project combines quantitative and qualitative analyses :

1. Quantitative study

Study of comparative prospective cohort clustered in two parallel groups:

Group 'Telemedicine': establishments providing care for the dependent elderly (EHPAD in french) equipped for telemedicine (teleconsultation, casualty) as part of the regional project of the Aquitaine Regional Agency of Heath telemedicine device deployment.

Control group: Defined and equipped for telemedicine EHPAD after matching on the number of residents, the GMP (average weighted GIR : "Groupes Iso Ressources" = score to reflects the average level of dependency of residents of a residential care facility for the elderly), the PMP (weighted average PATHOS = an evaluation system set up by the National Union of Clinical Gerontology and the Medical Service of the National Fund for Health Insurance for Salaried Workers), the distance to a hospital with an emergency shelter service.

The rate of unscheduled hospitalizations will be collected during follow-up visits in clinical departments of the healthcare of the Gironde (french department) by a research staff.

2 Qualitative study In the Group of nursing homes with telemedicine, said group "Telemedicine", will be identified four long-term care facilities, selected according to their degree of use of telemedicine (ratio number of teleconsultation per month / number of beds) (EHPAD 2 strong users, 2 nursing homes) low users) within these four long-term care facilities will be carried out observations of field and in-depth interviews with professionals, managers and attending physicians.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
373
Inclusion Criteria

Quantitative research:

  • All residents of nursing home men and women 65 years of age and more and likely to be eligible for a teleconsultation or a casualty because achieved one of the identified chronic pathologies as a reason for teleconsultation, will be included in both groups of long-term care
  • Medical professionals working in the nursing home agreeing to answer the specifics questionnaires

Qualitative study:

  • Doctors, physicians and coordinators nurses of Establishments Providing Care for the Dependent Elderly, nurses, orderly, psychologists, directors of Establishments
  • Having a professional activity in nursing homes selected
  • Having given their consent to participate in the study
Exclusion Criteria
  • Residents of long-term care facilities (quantitative study) Resident (or guardian/person) who expressed his opposition to participate in the study or not likely to be eligible for a teleconsultation or casualty Establishments Providing Care for the Dependent Elderly (qualitative) professionals
  • Professional who expressed his opposition to participate in the study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Establishments with telemedicine systemEvaluation of disease and follow-upEstablishments equipped for telemedicine (teleconsultation, casualty) as part of the regional project of the Aquitaine regional program telemedicine device deployment.
Establishments without telemedicine systemEvaluation of disease and follow-upDefined and equipped for telemedicine EHPAD after mating on the number of residents, the GMP (average weighted GIR), the PMP (weighted average PATHOS), the distance to a hospital with an emergency shelter service. The rate of unscheduled hospitalizations will be collected during follow-up visits in clinical departments of the healthcare of the Gironde by a research staff
Primary Outcome Measures
NameTimeMethod
Number of hospitalization not programmed residents on Medicine Surgery obstetrics (MCO)12 months

Number of hospitalizations not programmed residents on Medicine Surgery obstetrics (MCO) between the inclusion and 12 month

Secondary Outcome Measures
NameTimeMethod
Score of the specific questionnaire for measurement of the context organizational and Managerial in health care facilities12 months

Evaluate the impact of a strategy issued in EHPAD type teleconsultation or casualty on the quality of work life

the main diagnosis, coded by the International Classification of diseases for every hospitalization12 months

Evaluate the number of inappropriate hospitalization. The inappropriate hospitalization will be performed using the classification of Weissman. Weissman classification identifies causes of potentially preventable hospitalizations, from the main diagnosis, coded by the International Classification of diseases, version 10 (ICD10).

Trial Locations

Locations (24)

EHPAD CHU Bordeaux

🇫🇷

Pessac, Lormont, France

EHPAD Le home medocain Arsac

🇫🇷

Arsac, France

EHPAD Résidence l'Arousiney

🇫🇷

Gujan-Mestras, France

EHPAD Seguin

🇫🇷

Cestas, France

EHPAD Henry Dunant

🇫🇷

Bordeaux, France

EHPAD Le Clos Serena

🇫🇷

Bordeaux, France

EHPAD Grand Bon Pasteur

🇫🇷

Bordeaux, France

EHPAD Résidence les Carmes

🇫🇷

Bordeaux, France

EHPAD Cos villa Pia

🇫🇷

Bordeaux, France

EHPAD Home Marie Curie

🇫🇷

Villenave-d'Ornon, France

EHPAD Fontaudin

🇫🇷

Pessac, France

EHPAD Le Platane du Grand Parc

🇫🇷

Bordeaux, France

EHPAD Villa Bontemps

🇫🇷

Talence, France

EHPAD Residence Aime Cesaire

🇫🇷

Bordeaux, France

EHPAD résidence du Tertre

🇫🇷

Fronsac, France

Résidence de Médicis

🇫🇷

Mérignac, France

EHPAD Villa presentine

🇫🇷

Rauzan, France

EHPAD Jacqueline Auriol

🇫🇷

Saint Seurin sur l'Isle, France

EHPAD Le parc du Bequet

🇫🇷

Bègles, France

EHPAD Les coteaux

🇫🇷

Lormont, France

EHPAD Manon Cormier

🇫🇷

Bègles, France

EHPAD Douceur de France

🇫🇷

Gradignan, France

EHPAD Le rétou

🇫🇷

Lamarque, France

EHPAD Résidence La berge du lac

🇫🇷

Talence, France

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