Emergency intervention of hospitalisation at home in nursing home during the pandemic period of Covid-19

Background: In the context of the pandemic Covid-19, the Hospitalization A Home (HAH) of the Assistance Publique - Hopitaux de Paris (APHP) has implemented a new organisation with emergency interventions to meet the needs of residents in palliative care in nursing home. The objective of the study was to describe their clinical characteristics, the modalities of the intervention and their care pathways during the HAH intervention. Methods: This is a descriptive study on the emergency intervention of the HAH in 74 nursing home in the area of Ile-de-France during one month (April 2020) with a sample of 132 residents. The data collection included the socio-demographic and clinical characteristics of residents and on data about nursing home included. Results: Emergency intervention of the HAH in nursing home involved very elderly residents with severe functional disabilities and with signs of respiratory failure linked to the Covid 19. The intervention took place mainly during the day and the week with a territorial heterogeneity and with a double medical validation between the prescribers and the HAH physician. Seventy per cent of the residents died at their living place. Among nursing home included, they were of medium size, mainly with private status and a large majority had already collaborated with the APHP's HAH. Discussion/conclusion: Emergency intervention of the HAH in nursing home was feasible and responded to an unmeet need for palliative care residents. These results should allow the ongoing development of this new organization for elderly population living in private homes.