Evaluation of the Access to Healthcare Service

NCT07207499 | Not Yet Recruiting

• 2 other identifiers: 2023/0350/HP2023-A02103-42
• Study Type: observational
• Target: 9,280
• Locations: 1 country
• Sites: 1

Brief 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).

Conditions

Emergency Service, Hospital

Keywords

Access to Care Service (SAS); telephone patient regulation service

Outcome Measures

Primary Outcomes (1)

• Evaluate the savings in emergency room use attributable to the regulation system integrating the SAS compared to the standard control device

  Assessment of referral to an emergency department by the regulating physician who treated the patient (with or without urgent medical transport) by telephone call.

  day 7

Secondary Outcomes (5)

• Description of the guidance given by the regulating physician in each of the devices (secondary judgment criterion no. 1)

  Day 7

• Description of the guidance given by the regulating physician in each of the devices (secondary judgment criterion no. 1)

  Day 7

• Assessment of the patient's compliance rate with the guidance given by the regulating physician (secondary judgment criterion no. 2)

  Day 7

• Assessment of the patient's compliance rate with the guidance given by the regulating physician (secondary judgment criterion no. 2)

  Day 7

• Evaluation of the medical-economic impact of "SAS" regulation versus "standard" regulation (Qualitative component)

  Year 5

Interventions

control group ("standard" regulation device) OTHER

Evaluate the time spent in the emergency room of patients referred to the emergency room by the "standard" regulation system

intervention group Access to Care Service "SAS" OTHER

Evaluate the time spent in the emergency room of patients referred to the emergency room by the Emergency Care Access Service (SAS)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Users of the health system: The concept of users applies not only to the sick person and their loved ones but, more broadly, to any actual or potential user of the health system, in the health and medico-social fields, in establishments as well as in outpatient care or in home care

You may qualify if:

• For the primary analysis and secondary outcome measure 1:
• All calls to 116-117 or 15 in the Le Havre area over the 40 study periods,
• Non-opposition. Patients with a life-threatening emergency will be included in the primary analysis, even though there will be no pseudo-randomization of the systems for them. They are therefore included in the study.
• For the secondary analysis on patient compliance with the referral given by the regulating physician (secondary objective 2):
• Non-opposition of patients who used the SNP call for the primary analysis,
• Randomly selected by sampling calls to 116-117 or 15 made over the study periods defined by the protocol.
• For the qualitative component:
• Major,
• No opposition from regulators and major effectors of the SAS
• Or No opposition from adult health patients in the Le Havre area who have used the unscheduled care system (outpatient or inpatient).

You may not qualify if:

• For the primary analysis and secondary objective 1:
• Refusal to participate,
• Non-French speaking.
• For the secondary analysis on patient compliance with the referral given by the regulating physician (secondary objective 2) and for the qualitative component:
• Minor caller
• Refusal to participate (patient or caller or both),
• Non-French speaking (caller)

Sponsors & Collaborators

• University Hospital, Rouen: lead

Study Sites (1)

Le Havre Hospital Group,

Le Havre, 76083, France

Location

MeSH Terms

Conditions

Emergencies

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Central Study Contacts

Elsa EF FAGOT-GRIFFIN, Doctor

CONTACT

02 35 14 84 46; elsa.griffin@univ-rouen.fr

Benjamin BS SOUDAIS, Doctor

CONTACT

02 35 14 84 46; benjamin.soudais@univ-rouen.fr

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 26, 2025
• First Posted: October 6, 2025
• Study Start: December 1, 2025
• Primary Completion (Estimated): January 2, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: October 6, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)