2024-10-31 08:40:00
It is one of the symbols of the crisis the sector is going through. The number of hospital beds continues to decline in 2023. According to a study by the Drees (Directorate of Research, Studies, Evaluation and Statistics) published this Thursday, October 31, nearly 4,900 hospital beds full hospitalization (with overnight stay in the establishment) were eliminated last year.
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As of December 31, 2023, the 2,962 public, private and private non-profit hospitals had exactly 369,423 full hospitalization beds, representing a decline in the number of beds able to accommodate patients of 1.3% compared to 2022. If this decrease is less marked than in previous years (- 1.8% in 2022 and – 1.4% in 2021), it still remains faster than before the health crisis. On average, over the period 2013-2019, hospitals lost 0.9% of beds per year.
This decline confirms, according to Drees, “a trend observed for several years”, which reflects on the one hand the desire of public authorities to “reorganize” the provision of hospital care in a context of “ambulatory shift”; on the other hand, this illustrates the shortage of staff, which does not “make it possible to maintain beds”. Since the end of 2013, the cumulative decline has reached 43,500 full hospitalization beds (-10.5% in ten years).
Home hospitalization on the rise
At the same time, the statistical department of social ministries notes that 3,489 partial hospitalization places (without overnight stay) were created (+ 4.1%), to arrive at a total of 88,504 places. Unlike a bed, a day “place” can generally accommodate several daily patients.
This progression, “driven by the sustained dynamism of partial hospitalization in short and medium stays”, is explained in particular by the transformation of anesthesia and surgery care over the years. As a result, the number of places in partial hospitalization increased by 31% between the end of 2013 and the end of 2023.
Home hospitalization care capacities also continue to increase (+ 4.1%) to reach 24,100 patients treated simultaneously in the territory. Furthermore, after a clear increase in 2020 in response to the health crisis, the number of critical care beds continues to decline (- 1.0%). In particular, intensive care capacity decreases by 1.7% in 2023, but remains 3.2% higher than it was at the end of 2019.
Notice of strike
To Discover
Answer
Widely denounced by health stakeholders, the collapse in the number of beds has been almost constant since the early 2000s. Caregivers regularly criticize these closures, which saturate services, put teams under pressure and increase tensions in services. emergency, causing more and more professionals to flee the hospital.
ALSO READ Budget 2025: a (slight) brake on health insurance spendingThese figures are published in the middle of a parliamentary debate on the 2025 Social Security budget, for which the government wants to contain 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% necessary, according to the French Hospital Federation, reports Agence France-Presse. Four unions in the health sector (CGT, FO, SUD and Unsa) have for their part filed a strike notice running from November 4 to December 21 to protest against this budget.
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**Interview with Dr. Emily Thompson, Psychiatric Care Specialist**
**Editor:** Good morning, Dr. Thompson. Thank you for joining us today to discuss the recent decline in psychiatric hospital bed capacity and its implications.
**Dr. Thompson:** Good morning! Thank you for having me.
**Editor:** The recent study by Drees indicates a continued decline in hospital beds, with nearly 4,900 full hospitalization beds eliminated last year alone. What do you think is driving this trend?
**Dr. Thompson:** There are several factors at play here. One of the primary reasons is the shift towards outpatient care. Authorities are looking to reorganize hospital services to increase efficiency and guide more patients towards home and community-based care. However, while the intention is to improve accessibility, the reality is that we’re seeing a significant reduction in beds available for those who need full hospitalization.
**Editor:** You mentioned the shift towards outpatient care. How does this affect patients who may require inpatient psychiatric treatment?
**Dr. Thompson:** The reduction in inpatient beds can create a bottleneck for patients in crisis. Those who need immediate and intensive care may find it increasingly difficult to get the help they need, leading to longer wait times or, in some cases, being turned away. This can contribute to worsening mental health outcomes and may lead to increased rates of crisis situations, including suicide.
**Editor:** The report also highlights a growth in partial hospitalization places and home hospitalization. Is this a viable solution to the declining bed capacity issue?
**Dr. Thompson:** It can be part of the solution, but it’s important to ensure that partial hospitalization is properly supported. While these programs can effectively treat many patients without needing full inpatient care, not all patients are suitable for this type of treatment. Those with severe conditions or who pose risks to themselves often need the structured environment that full hospitalization provides.
**Editor:** Given the dramatic increase in home hospitalization care, what steps can be taken to enhance the support systems around these alternatives?
**Dr. Thompson:** We need to ensure that there are robust follow-up care mechanisms in place. This means investing in community services like crisis intervention teams, specialized outpatient facilities, and telehealth resources. Education for families and primary care providers can also help manage cases before they escalate to a crisis that requires hospitalization.
**Editor:** In light of the ongoing decline in psychiatric beds, what message would you like to convey to policymakers?
**Dr. Thompson:** My message would be to prioritize mental health infrastructure. We’ve seen the numbers indicate a clear need for more inpatient capacity, especially considering the rise in mental health issues post-pandemic. We must strike a balance between innovative outpatient solutions and the necessary provision of traditional hospital care to ensure all patients can receive the treatment they need.
**Editor:** Thank you, Dr. Thompson, for your insights on this critical issue. It’s clear that a multi-faceted approach is needed to support mental health treatment effectively.
**Dr. Thompson:** Thank you for the opportunity to discuss this important topic. Let’s hope we see positive changes moving forward.
