Hospitalisation à domicile et malades âgés

Do mobile hospital teams in residential aged care facilities increase health care efficiency: an evaluation of French residential care policy

“…To employ HAH, the RACF and the HAH team must first define together a care contract which defines the responsibilities of each. Thus, the use of HAH in RACF will depend on the motivation and financial incentives of these actors to introduce HAH in RACF [ 29 – 31 ]. In this section, I summarize the costs and benefits that may be associated with HAH intervention for the facility, the hospital, the HAH team and the primary care (referring) physician [ 32 , 33 ].…”

“…HAH in RACF necessarily involves collaboration between the HAH team, the person's primary care physician, and the caregivers in RACF, but also sometimes the hospital physicians when they prescribed the HAH. This interaction between care providers in community, hospital, and RACF can improve care coordination and quality [ 31 ] although, it is difficult to measure the cost/benefit ratio of HAH in RACF for these care providers. For all care providers (RACF staff, HAH team and the primary care physician), the need to coordinate care and work together can be costly (administrative burden, differences in culture, hierarchy, etc.)…”

“…Moreover, for the resident, the use of HAH in RACF is financially neutral because it is fully funded by the SHI. However, qualitative studies in France report that there are benefits for the residents since HAH allows residents to stay in a familiar environment with the personnel they know compared to a hospital admission [ 29 – 31 ]. Caregivers of RACF residents can also prefer HAH because they do not have to manage a hospital transfer and they remain in contact with the same care providers in the facility.…”