NCT07207499

Evaluation of the Access to Healthcare Service

Evaluation of the Access to Healthcare Service Established in the Le Havre Area

• Status: Not Yet Recruiting
• Phase: —
• Study type: Observational
• Enrollment: 9,280 (estimated)
• Sponsor: University Hospital, Rouen · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Accepted

Summary

The Healthcare Access Service (SAS) of the Emergency Department of the CHG du Havre is a telephone regulation (i.e., orientation) service for users of Le Havre. Access to this service, during a call, gives access to a Medical Regulation Assistant (ARM) (first contact) who determines, in less than 30 seconds, the degree of urgency applicable to the "caller" in order to direct the latter to the "primary care" channel or the "urgent medical assistance" channel. Thus, in the context of a non-life-threatening emergency, this service allows access during the day to a consultation with a healthcare professional. When their primary care physician is not available, the "caller" is directed by a Medical Regulation Assistant (ARM) to an Unscheduled Care Operator (OSNP) who can provide medical advice, offer a teleconsultation, or direct them, depending on the situation, to an unscheduled care consultation in an office, at home, or at a health center. This service therefore allows for patient referrals and gives patients direct access to healthcare professionals known as "performers" of primary care (doctor, midwife, dentist) within very short timeframes (most often during the day, and 48 hours at the latest). This medical regulation is made possible through the use of a shared calendar between independent healthcare professionals and the healthcare access service (SAS). In the event of a life-threatening emergency, the "caller" is directed by the Medical Regulation Assistant (ARM) to an emergency Medical Regulation Assistant (ARM) who assesses the actual degree of urgency, the medical needs and the possibility of triggering the SAMU intervention. Before its implementation, the patient journey was complicated by the lack of a link between regulation and so-called "field" medical professionals, now called "performers" of primary care. Indeed, the initial so-called "standard" regulation system did not have a "primary care" referral system (with very rapid appointments to primary care for semi-emergencies (unscheduled community care)), potentially saving recourse to emergency services or medical time in situations not requiring medical advice (request for contact details of on-call pharmacy).

Detailed description

The SAS represents an evolution of SAMU medical regulation, no longer based solely on emergency medical assistance (the standard regulation system), but also combining it with outpatient medical regulation. It is therefore a multi-professional platform that saves medical time by delegating some of the tasks (pre-triage, administrative information gathering², scheduling unscheduled care appointments) to non-medical personnel specifically trained for the task (Unscheduled Care Operators (OSNP)). This study seeks to assess the benefits of this new system in a context of very high social expectations. A comparative assessment is necessary between the Emergency Department's Access to Care Service (SAS) and the former "standard" regulation system to understand the overall impact of the "SAS" on the Le Havre healthcare area. This study has multiple perspectives: * For users, the aim is to compare the care trajectory of regulated users (healthcare professional(s) seen, emergency room stay, hospitalization, etc.) by the "SAS" versus "standard" regulation and to understand the use of Unscheduled Care (SNP) provided in the Le Havre area; * To assess the medical-economic impact of the "SAS" versus "standard" regulation. * For healthcare professionals, it is a question of understanding and describing the interactions between the "effectors" of primary care (doctor, midwife, dentist) and the regulators involved (Unscheduled Care Operator (OSNP) (via the Medical Regulation Assistant (ARM))) in the "SAS"

Conditions

• Emergency Service, Hospital

Interventions

Type	Name	Description
OTHER	control group ("standard" regulation device)	Evaluate the time spent in the emergency room of patients referred to the emergency room by the "standard" regulation system
OTHER	intervention group Access to Care Service "SAS"	Evaluate the time spent in the emergency room of patients referred to the emergency room by the Emergency Care Access Service (SAS)

Timeline

• Start date: 2025-12-01
• Primary completion: 2027-01-02
• Completion: 2027-06-01
• First posted: 2025-10-06
• Last updated: 2025-10-06

Locations

1 site across 1 country: France