Ruelle Y, Bessah N, Hami L. [The general practitioner in old age homes : an incongruous actor ? Study in old-age homes in a deprived area].
Rev Epidemiol Sante Publique 2023;
71:101423. [PMID:
36731385 DOI:
10.1016/j.respe.2023.101423]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023] Open
Abstract
CONTEXT
Residential facilities for dependent elderly people have difficulties ensuring medical follow-up of their residents by general practitioners. The barriers to medical visits are well-known. Seine-Saint-Denis is particularly affected by the medical demography crisis.
OBJECTIVES
To describe the organization of visits by general practitioners in residential facilities for dependent elderly people in Seine-Saint-Denis. To assess the influence of the institutions' status on this organization.
METHOD
Quantitative descriptive cross-sectional study of 65 facilities in Seine Saint-Denis. A questionnaire drawn from the literature on known barriers to medical visits was used.
RESULTS
Fifty institutions (76.9%) contributed. Most visits (88.0%) took place in patients' rooms. When the practitioner arrived, the patient was present at the site in 80.0% of the facilities, especially when they were private and associative (p = 0.01). The doctor was accompanied by a staff member in 30.0% of the facilities, especially when they were for-profit (p = 0.02). Exchanges between general practitioners and the staff were sporadic and unorganized. All in all, the public facilities seemed to be less well-organized to receive general practitioners.
DISCUSSION
Residential facilities for the elderly do not seem to have implemented specific organization for visits by general practitioners, who are not integrated in the staff.
CONCLUSION
Experiments with doctors gainfully employed in institutions could be carried out, following the example of several foreign countries.
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