Implementation of a Territorial Geriatric Hotline in Southwestern France: A monocentric observational study to improve access to geriatric expertise

Background: France is experiencing rapid population aging, increasing demand for healthcare services and pressure on unscheduled care pathways for frail and multimorbid older adults. Many transfers to acute care, including emergency departments, may be avoidable with timely geriatric expertise. In 2024, a territorial geriatric hotline was implemented at Toulouse University Hospital to provide community-based physicians with rapid access to geriatric advice and optimize patient care pathways. The purpose of this study was to describe the development, implementation, and early activity of a territorial geriatric hotline for community-based physicians and assess its feasibility and impact on patient orientation. Methods: We conducted a monocentric, observational, descriptive study of the Haute-Garonne territorial geriatric hotline (June 2024–November 2025). The hotline was developed with 15 local professional healthcare networks and provided rapid access to geriatricians for general practitioners. Only calls requesting general geriatric advice or hospitalization were analyzed; calls related to supra-specialty expertise (onco-geriatrics, cardio-geriatrics, dementia care and palliative care) were redirected internally. Data collected included patient characteristics, reasons for the call, and patient orientation. Analyses were descriptive. Results: During 18 months, 3,626 calls were received, with monthly activity increasing from 100 to 425 calls. A total of 393 calls with complete data were analyzed (mean age 84.3 ± 7.6 years; 55.5% women), placed by 243 general practitioners. Common reasons for calls included impaired general condition (19.3%), falls (12.5%), neurodegenerative diseases (11.2%), hematology/onco-geriatrics (10.4%), nutrition/metabolic disorders (9.4%), and pain (8.1%). Following calls, patient orientation included hospitalization in an acute geriatric unit (35.4%), provision of geriatric advice (27.2%), day hospital admission (16.0%), reorientation to another care pathway (7.6%), and emergency department referral (7.4%). Conclusion: A territorial geriatric hotline integrated into local professional healthcare networks is feasible and widely utilized. It facilitates rapid access to geriatric expertise, improves patient orientation, and supports alternatives to emergency department transfers. The model demonstrates how limited geriatric resources can be leveraged to strengthen interprofessional coordination, optimize care pathways, and enhance equity in access to geriatric care. These results provide a basis for further evaluation of its impact on patient outcomes and healthcare system efficiency.