2024-10-31 06:42:00
This is one of the symbols of the hospital crisis: in 2023, almost 4,900 complete hospitalization beds (with overnight stays in the facility) were eliminated, confirming a continuous decline in supply, with 43,500 beds lost since the end of 2013, This was stated in a study by the Directorate of Research, Studies, Evaluation and Statistics (Drees) published Thursday 31 October.
As of December 31, 2023, according to the Drees, the 2,962 public, private and private non-profit hospitals had exactly 369,423 full inpatient beds, which is 4,867 fewer beds than in 2022 (-1.3%). At the same time, 3,489 partial hospitalization places were created – without overnight stays – (+4.1%), for a total of 88,504 places. Unlike a bed, a ” place “ the nursery can generally accommodate several daily patients.
According to Drees, the decrease in beds is confirmed “a trend observed for several years”reflecting on the one hand the desire of public authorities to do so “reorganize” care for more “outpatient”and on the other the lack of personnel, which “cannot maintain” all beds are open.
“Lack of attractiveness”
Since the end of 2013, healthcare facilities have lost 43,500 full inpatient beds, representing a 10.5% reduction in supply over ten years. At the same time, approximately 20,900 partial hospitalization places were created (+31%).
The decline in full hospitalization capacity is “Faster” in the last four years compared to before the health crisis: it decreased on average by around 0.9% per year in the period 2013-2019.
The promise of former Health Minister Aurélien Rousseau in the autumn of 2023 a “reopen several thousand beds by the end of the year”it was therefore not held. If the beds close, “It’s not for budget reasons”but say “lack of attractiveness” caring professions, he then assured.
Decrease in psychiatric beds
There is, however, a decrease “less marked” in 2023 compared to 2022, when facilities lost more than 6,700 full inpatient beds.
Drees also notes, in 2023, a sharp decline in psychiatric beds (-2.4%), mainly in the public sector. However, home care capabilities continue to increase (+4.1%) until reaching 24,100 patients treated simultaneously in the area.
Widely denounced by healthcare workers, the collapse in beds has been almost constant since the beginning of the 2000s, according to data available on the website of the Institute for Research and Documentation in Health Economics. The number of hospital sites also continues to decline “under the effect of reorganizations and restructuring” (− 160 public or private establishments between 2013 and 2023, or − 5.1%), with a greater decline in the public sector than in the private sector.
Strike notice
Health workers regularly criticize these bed closures, which saturate services, put pressure on teams and increase tensions in emergency departments, forcing more and more professionals to flee hospital.
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These data are published in the midst of the parliamentary debate on the 2025 social security budget, whose government wants to limit the deficit to 16 billion euros compared to 18 billion in 2024. The increase in health spending dedicated to the hospital sector will be limited to + 3.1%, far from the +6% needed, according to the French Hospital Federation (FHF, public sector).
Four unions in the health sector (CGT, FO, Sud and UNSA) have for their part announced a strike from 4 November to 21 December to protest against this budget. The left, for its part, intends to have the National Assembly vote by December on a socialist bill – already validated by the Senate – to set a minimum number of healthcare workers per patient admitted to hospital.
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Interview: The Hospital Crisis in Numbers
Time.news Editor: Welcome to Time.news. Today, we have the privilege of speaking with Dr. Sophie Bernard, a healthcare policy expert, to discuss the alarming trends in our healthcare system highlighted by the recent study from the Drees. Welcome, Dr. Bernard.
Dr. Sophie Bernard: Thank you for having me. It’s a pleasure to be here.
Editor: To kick things off, the Drees report mentions a staggering reduction of nearly 4,900 full hospitalization beds in 2023 alone. Can you shed some light on why we’re witnessing such a continuous decline?
Dr. Bernard: Absolutely. The decline in full hospitalization beds is a multifaceted issue. Firstly, there’s been a significant push from public authorities to reorganize healthcare towards more outpatient services. The idea is to treat patients without needing overnight stays, thus creating more partial hospitalizations, which increased by 4.1% this year.
Editor: That makes sense. But the report also mentions that the decrease in full beds is not purely due to budget constraints. It attributes it to a “lack of attractiveness” in healthcare professions. Can you elaborate on that?
Dr. Bernard: Certainly. The working conditions in hospitals have been a growing concern for many healthcare professionals. Long hours, high patient-to-staff ratios, and the pressures of a struggling system have made the profession less attractive. Consequently, we’re seeing difficulties in hiring and retaining staff, which directly affects our ability to keep all beds open.
Editor: It sounds worrying. Since 2013, the healthcare system has lost a total of 43,500 full inpatient beds. How does this affect patient care?
Dr. Bernard: Loss of beds means that when patients need admissions, they may be turned away or face long waits, contributing to overcrowded emergency rooms. This doesn’t just impact care for patients needing hospital treatment but also puts immense pressure on frontline healthcare workers, leading to burnout and staff shortages.
Editor: The report also highlights a concerning decline in psychiatric beds, which are crucial for managing mental health crises. What’s your take on the implications of this?
Dr. Bernard: The decline in psychiatric beds is particularly concerning given the rising incidence of mental health issues, especially post-COVID. A reduction in these specialized resources can lead to inadequate care for patients in need, which could increase the burden on emergency services—creating a cycle that is hard to break. It’s a clear signal that we need to rethink our mental health strategies.
Editor: It’s a complex problem indeed. As a potential solution, the former Health Minister promised in 2023 to reopen “several thousand beds.” Given the current trajectory, do you think this is feasible?
Dr. Bernard: Unfortunately, it appears ambitious given the current trends. A promise to reopen beds without addressing the underlying staffing shortages and implementing structural changes in the healthcare system seems unrealistic. It requires a comprehensive approach to make the profession more appealing and sustainable for future healthcare workers.
Editor: Given the increasing pressures, what would you suggest as immediate steps to address this hospital crisis?
Dr. Bernard: We need to prioritize improving working conditions, provide incentives for health professionals, and bolster mental health services. Moreover, we should explore innovative care models that rely less on hospital admissions, such as telehealth and community-based care, to alleviate the burden on our hospital system.
Editor: Thank you, Dr. Bernard. Your insights shed light on a critical issue that affects us all. It’s clear we need to address both structural and cultural changes in our healthcare system to navigate these challenges effectively.
Dr. Bernard: Thank you for having me. I appreciate the opportunity to discuss this important topic.
Editor: And thank you to our readers for tuning in. This is an evolving situation that affects all of us, and we’ll continue to track developments closely.