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BMC Palliative Care
Published in: BMC Palliative Care 1/2016

Open Access 01-12-2016 | Research article

Reasons for transferral to emergency departments of terminally ill patients - a French descriptive and retrospective study

Authors: Pierre Cornillon, Sébastien Loiseau, Bruno Aublet-Cuvelier, Virginie Guastella

Published in: BMC Palliative Care | Issue 1/2016

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Abstract

Background

Patients under palliative care and in hospital-at-home services are frequently transferred to emergency departments.
We set out to identify the reasons for these presentations to determine the proportion that might be avoidable.

Methods

We conducted a retrospective study by assessment of patient files.
We studied admissions to four emergency departments in an area of France (Puy-de-Dôme) between September 2011 and August 2013. Reasons for transfer and diagnostic conclusion by emergency doctors were noted. We collected date of admission, time spent, investigations and treatments performed and patients’ outcomes after the medical conclusions. We also determined whether patients called the hospital-at-home service before going to the emergency department. From these data we discerned potentially avoidable and unavoidable consultations.

Results

We identified 52 transfers of patients from home to emergency departments. The most frequent reasons were: generalized weakness (11 cases), social isolation (8 cases) and end of life (7 cases). For 58 % of presentations, the investigations and treatments performed did not require presentation to an emergency department; 34 % of patients returned home after the visit, 41 % remained for simple observation and 20 % remained to receive special care. Two patients died in the emergency department. In 86 % of cases, presentations occurred when primary care was less readily available, and patients called home care services in only 42 % of cases before going to emergency departments.

Conclusions

Half of the transfers to emergency departments were potentially avoidable for terminally ill patients in home care. To reduce this proportion we need to promote access to primary care, educate patients in hospital-at-home service and train care-givers and doctors in palliative medicine.
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Metadata
Title
Reasons for transferral to emergency departments of terminally ill patients - a French descriptive and retrospective study
Authors
Pierre Cornillon
Sébastien Loiseau
Bruno Aublet-Cuvelier
Virginie Guastella
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2016
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-016-0155-y

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