[Non-justified visits to emergency units. Proposal of differentiated care].
OBJECTIVE
The number of visits to emergency units in public hospital settings in France increases every year. The adequation between admission to an SAU--Service d'accueil d'urgence (emergency unit) and the clinical status of the patient must be checked to improve handling upstream of the SAU.


METHODS
A prospective study was conducted in the SAU of the University Hospital in Nantes to assess the proportion of patients who would benefit from direct hospitalisation, scheduled in a department of specialised or polyvalent medicine.


RESULTS
This proportion was of 10%. Seventy-three percent of the patients were aged over 60. They were referred in 77% of cases by their treating physician and in 10.4% of cases by the physician on duty. Thirty-three percent of cases were non-specified organ diseases, 20% were dermatological affections, 12% broncho-pulmonary infections and in the same proportion rheumatological pathologies; other affections were rare.


CONCLUSIONS
The results of this study must be confirmed in a pilot study in which the general practitioner would refer any patient, that he would have sent to an SAU, directly to a medical department without passing through the SAU. To do so, using a cell phone, the practitioner would contact the hospital physician who would find a hospital bed. The impact of this new modality of hospitalisation on the SAU could be assessed in terms of the number of admissions avoided to the SAU.
Derame
Geneviève
G
Unité fonctionnelle de médecine polyvalente urgence, Service d'accueil des urgences, Hôtel-Dieu, CHU Nantes.
El Kouri
Dominique
D
Hamidou
Mohamed
M
Carré
Emmanuel
E
Potel
Gilles
G
D000368:Aged; D003695:Delivery of Health Care / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006291:Health Policy; D006760:Hospitalization; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D011446:Prospective Studies; D012017:Referral and Consultation