title: [Appropriateness of direct admissions to acute care geriatric unit for nursing home patients: an adaptation of the AEPf GRID].
abstract: The patient population staying in nursing homes is increasingly vulnerable and dependent and should benefit from a direct access to an acute care geriatric unit. Nevertheless, the easy access by a simple phone call from the general practitioner to the geriatrician, as well as the lack of orientation of these patients by emergency units, might lead to inappropriate admissions. This work studied the appropriateness of direct admissions of 40 patients living in nursing home in an acute care geriatric unit. Based on the AEPf assessment grid, 82.5% of these admissions were considered as appropriate (52.5%) or justified (30% based on an expert panel decision), and 17.5% were inappropriate. In conclusion, the process of direct admission does not seem to increase the rate of inappropriate admissions. Some actions could decrease this rate: implementation of geriatric mobile teams or psychogeriatric mobile teams intervening in nursing home, a better and more adapted use of ambulatory structures, a better information to the general practitioners. In order to reduce the intervention of the panel of experts, an adaptation of the AEPf assessment grid to these geriatric patients has been proposed. The "AEPg" assessment grid should benefit from a validation study.
authors: Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France.
authors: Dalia
authors: D
authors: Abdoulhadi
authors: Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France.
authors: Pascal
authors: P
authors: Chevalet
authors: Service d'évaluation médicale et d'épidémiologie, Pôle santé publique et santé au travail, CHU de Nantes, France, et EA4275-Sphere, Biostatistiques, pharmaco-épidémiologie et mesures subjectives en santé, faculté de pharmacie, Nantes, France.
authors: Leila
authors: L
authors: Moret
authors: Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France.
authors: Marie-Hélène
authors: MH
authors: Fix
authors: Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France.
authors: Marine
authors: M
authors: Gégu
authors: Unité de géronto-psychiatrie, CHU de Nantes, France.
authors: Philippe
authors: P
authors: Jaulin
authors: Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France.
authors: Gilles
authors: G
authors: Berrut
authors: Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France.
authors: Laure
authors: L
authors: de Decker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D015577:Geriatric Assessment; D005853:Geriatrics / Q000592:standards*; D006748:Hospital Departments; D006801:Humans; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes; D010343:Patient Admission / Q000592:standards*; D010361:Patients
keywords: acute care geriatric unit; appropriateness evaluation protocol; appropriateness of admission; elderly; nursing home