Interventional Trial in Primary Care of Medico-social Mediation on the Prevention of the Return to Emergencies Among People in a Precarious Social Situation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 724
- 试验地点
- 1
- 主要终点
- numbers of readmission to hospital emergencies
研究概览
简要总结
This research aims to evaluate a new mode of care for precarious public through a medico-social mediation device after emergencies, with the aim of improving their care and to prevent possible complications.
The main objective is to evaluate the effectiveness of management by a medico-social mediation device set up within 48 hours after leaving emergency on the 90-day emergency readmission rate. people living in precarious situations.
prospective randomized interventional trial with two arms. Patients will complete questionnaires assessing precariousness, quality of life, health literacy, and time perspective. Eligible patients (726 subjects) are randomized : control group (usual management) or experimental group (patient is contacted within 48 hours by a medico-social mediator familiar with the territory), and followed for 90 days by the latter, in order to optimize and secure the care path.
Readmissions are identified from emergency database and Regional Emergency Terminal and documented.
Patients in the experimental group benefit from the support of a local health mediator who carries out a diagnosis of the person's needs in order to follow his or her care path in an optimal way. It implements and ensures with the patient and his entourage the follow-up of the care through his network of professionals of the social sector and the health.
The study will be under the responsibility of a multidisciplinary scientific committee experienced in public health, epidemiology and social psychology of health, in the field of emergencies, precariousness and medico-social mediation, and excellent knowledge. territories concerned.
详细描述
This research aims to evaluate a new mode of care for precarious public through a medico-social mediation device after emergencies, with the aim of improving their care, to prevent possible complications of diseases related to poor / no return home care, to improve the quality of life of the people concerned, and to participate in the decongestion of emergencies.
The main objective is to evaluate the effectiveness of management by a medico-social mediation device set up within 48 hours after leaving emergency on the 90-day emergency readmission rate. people living in precarious situations.
Secondary objectives:
- Evaluate the effectiveness of the studied CEP on the 180-day emergency readmission rate, the hospitalization rate at 30, 90 days and 180 days, the number of readmissions to emergencies within 30, 90 and 180 days of follow-up, duration of hospitalizations occurring within 180 days, subgroups of patients, reasons for readmissions to the emergency department,
- Evaluate the impact of health literacy and temporal awareness levels on the 90 day emergency readmission rate,
- Evaluate the impact of the initial quality of life on the 90-day readmission rate,
- Identify predictive factors for readmission to emergencies at 30, 90 and 180 days.
Methodological approach: prospective randomized interventional trial with two arms.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Admitted to emergencies,
- •Social precariousness score at the EPICES scale,
- •Having made at least one visit to an emergency department during the 90 days prior to inclusion,
- •Arriving on their own or being transported to a recumbent position by firefighters or an ambulance,
- •Volunteers to participate in the study ,
排除标准
- •Having a score of social precariousness according to the EPICES scale lower than 30, Transferred from a medico-social institution, Unable to answer a questionnaire, face-to-face with an interviewer, either for medical reasons Coming to emergencies for / with a psychiatric decompensation and / or presenting a serious mental illness and / or under the influence of psychotropes, Residing outside the areas of residence targeted by the research, Refusing to participate in the study , In situations of legal incapacity to fulfill informed consent, in particular persons under guardianship or trusteeship.
研究组 & 干预措施
control group
usual charge
experimental group
Mediation:
The mediator will intervene on several levels: planning of care according to the medical prescriptions on a support adapted and comprehensible by the patient according to his level of health literacy and his linguistic capacities, coaching on the management of the chronic diseases, possible orientation towards a workshop of therapeutic education, appointments calendar, clear indication of treatment changes, provision of contact information for allied health professionals , assistance in making appointments, possible accompaniments at a professional health.
干预措施: mediation (Other)
结局指标
主要结局
numbers of readmission to hospital emergencies
时间窗: 90 days
90-day readmission rate to hospital emergencies
次要结局
未报告次要终点