Evaluation of the Access to Healthcare Service

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"

Inclusion criteria

• 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).

Exclusion criteria

• 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)
• Only for adult healthcare users in the Le Havre area included in the qualitative component: Not having the independent capacity to use the SNP. Non-use of the SAS will not be a criterion for exclusion.