Reorganisation of acute stroke care in Central Denmark Region. Increased use of geriatric Early Home Supported Discharge services (EHSD)

Abstract

Methods.– This experiment was set up by representatives of the Regional Union of General Practitioners (GP), and both the Pole of Gerontology and the Direction of the University Hospital of Bordeaux. The missions of the hotline were: (1) to meet the expectations of GPs by allowing a direct call with a geriatrician every day, Monday to Friday (9 a.m. to 7p.m.) and (2) to give medical advices and alternatives to ED admissions, i.e., geriatric consultation, day hospital, and programmed geriatric medicine hospitalizations. Results.– A total of 714 calls were recorded (Nov. 2010–Feb. 2012) for the management of 230 older persons (mean age 86.2±6.2 years). The reasons for call were most of the time management of behavioral disorders (29.5%), unexplained asthenia (17%), repeated falls (13%) and complex social problems (10.3%). Only 4.3% of the patients were directly admitted to the ED and the hotline permitted to avoid ED admissions in 81.4% of cases. The hotline permitted to give advices to GPs (38.3%), and to organize geriatric consultations (5.3%), day hospital (9.2%) or hospitalization in geriatric medicine (42.9%). In conclusion, this hotline permitted to avoid ED admissions and to improve continuity of care for older patients.