The trajectory initiated over the last twenty years continues. The hospital has fewer and fewer full hospitalization beds with the closure of 6,700 of them in 2022. As of December 31, 2022, the 2,976 public and private hospitals had exactly 374,290 full hospitalization beds, i.e. decrease of 1.8% compared to the previous year, according to the report from the Statistical Directorate of Social Ministries (Drees) published Wednesday.
Health establishments have, at the same time, created 2,591 partial hospitalization places, without a night spent in the establishment (+3.1%), to arrive at a total of 85,015 places. Unlike a bed, a day “place” can generally accommodate several daily patients.
Nearly 40,000 beds eliminated in ten years
These figures, observed in both the public and private sectors, illustrate “a trend observed for several years”, which “reflects the desire” of the public authorities to reorganize the supply of hospital care towards more “ambulatory”, but also the shortages of staff, which “do not allow beds to be maintained”, according to the authors of the study. Since the end of 2013, a total of 39,000 full hospitalization beds have been eliminated (-9.4% in nine years), and 17,400 partial hospitalization places have been created.
The collapse in capacity has also been almost constant since the beginning of the 2000s, according to data available on the Irdes website (Institute for Research and Documentation in Health Economics). Caregivers regularly denounce these bed closures, which saturate services, put teams under pressure and increase tensions in emergency services.
Lack of attractiveness of the profession
“My only fight for the public hospital is the reopening of the beds, even if this is not very good news for Ondam (National Objective for Health Insurance expenditure),” said the minister. of Health Aurélien Rousseau during a hearing in mid-October at the National Assembly.
If the beds close, according to him, “it is not for budgetary reasons”, it is because of “lack of attractiveness” of the care professions. And the government is not “standing idly by”, he defended, referring to the large budgets allocated during the Ségur de la Santé, or the recent increases in night work. At the end of November, he promised to “reopen several thousand beds by the end of the year”.
A faster decline since Covid
In total, nearly 29,800 beds were eliminated over the period from the end of 2016 to the end of 2022, mainly corresponding to the presidency of Emmanuel Macron. That is much more than under his predecessor François Hollande (-15,000 between the end of 2012 and the end of 2017), but significantly less than during the five-year term of Nicolas Sarkozy (-37,000). Capacity has also decreased “more rapidly” since 2020 than before the Covid-19 epidemic, notes Drees in its study.
The health crisis can “explain an increased decline”, due in particular to the temporary reassignment of intensive care staff, the deprogramming of care or even the transformation of double rooms into single rooms. However, the decline observed in 2022 is the “most marked”, note the authors. Home hospitalization (HAD) saw its capacity increase by 1.6%, after a “jump” of 10.5% in 2020, and 6.8% in 2021.