title: [Qualitative and quantitative evaluation of an internal medicine assistance line dedicated to the diagnosis and treatment of diseases for general practice].
abstract: OBJECTIVE
  Clinical reasoning and treatment challenges within the scope of general practice led to the development of an internal medicine assistance line provided by Nantes University Hospital. The primary outcome of this study was to describe callers' profile, their requests and answers provided.
  
  
  METHODS
  A prospective, cross-sectional, observational, descriptive study was undertaken. For each call were identified the calling physician, her/his specialty and work setting, the call's object and adequacy, the answer provided, the time needed to connect with the assistance line, the time devoted by the internal medicine physician to provide an answer to the request, and whether the assistance line prevented a visit to the emergency room. Each calling physician was then called back to obtain demographic and professional characteristics, and data relating to the call and to the assistance line.
  
  
  RESULTS
  Sixty-three days were analyzed and 276 calls identified. The 237 identified calling physicians were mainly females (54%, n=93), with a mean age of 46 years, graduated from Nantes University (65%, n=86), practicing ambulatory general medicine (69%, n=164) in Loire-Atlantique department area (82%, n=176) for a mean duration of 15 years. Calls were mostly associated with diagnostic challenges (61%, n=166) concerning clinical issues (57%, n=155). A sole telephone advice was the main type of answer provided (56%, n=147) and a visit to the emergency room was prevented for 17% of calls.
  
  
  CONCLUSIONS
  The assistance line activity is adequate with its missions and seems to facilitate patients' healthcare delivery advocating for the development of similar structures in other units. Improvements relating to the information, availability and physicians' training should be considered.
authors: Département de médecine générale, faculté de médecine, 1, rue Gaston-Veil, 44000 Nantes, France. Electronic address: jeanmariecastillo@gmail.com.
authors: J-M
authors: JM
authors: Castillo
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: C
authors: C
authors: Agard
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: M
authors: M
authors: Artifoni
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: J-M
authors: JM
authors: Brisseau
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: J
authors: J
authors: Connault
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: C
authors: C
authors: Durant
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: O
authors: O
authors: Espitia
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: A
authors: A
authors: Masseau
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: A
authors: A
authors: Neel
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: F
authors: F
authors: Perrin
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: M-A
authors: MA
authors: Pistorius
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: B
authors: B
authors: Planchon
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: T
authors: T
authors: Ponge
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: M
authors: M
authors: Hamidou
authors: Service de médecine interne, CHU de Nantes, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: P
authors: P
authors: Pottier
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making / Q000379:methods; D003430:Cross-Sectional Studies; D004194:Disease; D005260:Female; D005602:France / Q000453:epidemiology; D058006:General Practice / Q000379:methods / Q000458:organization & administration / Q000592:standards; D015277:Hotlines / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000379:methods / Q000458:organization & administration / Q000592:standards; D008297:Male; D008875:Middle Aged; D017216:Telemedicine / Q000379:methods / Q000592:standards; D013689:Telephone
keywords: Clinical reasoning; Decision making; Décision médicale; General practice; Internal medicine; Médecine générale; Médecine interne; Raisonnement clinique; Thérapeutique; Treatment