The integration of physicians in nursing homes has a positive impact on the perceived quality of care[L’intégration de médecins prescripteurs en EHPAD : une amélioration de la qualité des soins perçue]

Introduction: Since 2017, the Regional Health Agency of 'Île-de-France' has implemented an experiment to subsidize the recruitment of part-time doctors in nursing homes, so that residents without a primary care physician can benefit from regular medical follow-up. Purpose of research: The purpose of the study is to estimate the effects of this experiment: how is it implemented? What are its effects on the perceived quality of care? Method: The method used was based on a qualitative survey involving semi-structured individual or group interviews. On the whole, 20 professionals, one resident, and two daughters of residents were interviewed in four different nursing homes. Results: The investigation shows that this experiment addresses an unmet medical need. However, the recruiting of doctors appears to be difficult and significant delays have been noted. The experimentation is considered to be beneficial by professionals and recipients: It provides an opportunity to re-evaluate prescriptions in time, to prevent the deterioration of the residents' health and to reduce the need for emergency services. These physicians are involved in the care for cognitive disorders and play an important role in the support of the end-of-life. Conclusions: The experimentation has a positive effect on the perceived quality of care, according to professionals as well as residents or their relatives, which could provide a rationale for its sustainability or even its extension.