the Covid-19 crisis hastened the closure of beds in 2020

Between the end of 2019 and the end of 2020, the reception capacities fell by 1.2%, confirms a report by DREES, published on Tuesday morning.

Between the end of 2021 and May 2022, the closing of hospital beds sparked the presidential campaign. A few months later, DREEs published this Tuesday an inventory of the state of health establishments in 2020, year 1 of the Covid-19 pandemic. The search confirms the first estimates of the statistical service included in the Ministry of Health, from last September: if the number of full hospital beds – in other words, with one night stay – is in low slope in ten years, the Covid -19 crisis highlights this trend in 2020.

In total, 4,900 beds were closed in 2020, a decrease of 1.2% compared to the end of 2019, says the report, with reception capacities reaching 387,000 beds at the end of the year. This decline is more marked than the dynamics of previous years, which averaged -0.9% per year between 2013 and 2019.

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The fall in the number of beds should be analyzed in the context of the shift towards ambulatory care – that is to say without overnight stays – in the work of the last twenty years in the hospital. If it is more marked that year, “this is probably related to the context of the Covid-19 epidemic and its consequences on hospitalization capacities and hospital human resources“said the Drees. Many factors have been done, including the deprogramming of non-urgent operations, the reassignment of some staff to critical care services, as well as the change of multiple double rooms into one room to prevent the spread of the virus.

Increasing the number of critical care beds

This decrease, however, is not proportional to the simultaneous decrease in the overall activity of the hospital, caused by the health crisis.“, qualified in the document: the deprogramming of non-emergency care, due to the pandemic, is one of the reasons, with preventive measures and barrier actions as well as the increase in the non-use of hospitals, due to fear of being contaminated with Covid.

This unprecedented decline in hospital activity has also weighed on partial hospitalizations, which increased by 2.5% per year on average from 2013 to 2019. In 2020, by way of comparison, they increased by only 1.7% (+1300 places). An increase”mainly driven by private clinics, while the health crisis seems to slow down the dynamics of public hospitals and private non-profit establishments“, determines the statistical service. Likewise, the health crisis has reduced the number of visits to the emergency room (-17.3% compared to 2019), marking “a break in the continuous and dynamic growth observed since 1996“.

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As DREES noted in September, while the number of full hospital beds fell between the end of 2019 and the end of 2020, the Covid-19 pandemic led to a significant increase in critical care capacities. -care, which supports patients whose health condition is very worrying. The latter were already on an upward trend before the crisis (+ 6.9% between the end of 2013 and the end of 2019), but they literally jumped because of the health crisis: the number of critical beds in care increased by 3, 6% between the end of 2019 and the end of 2020, “three times higher than the trend of the previous six years“, introduces DREES. In particular, the number of intensive care beds increased by 14.3%.

Lack of staff

It should be noted, however, that these data on hospital beds, especially in critical care, are from a cost made on December 31 of each year. gold,”with the health crisis linked to the Covid-19 epidemic, the number of beds experienced strong differences in the year 2020, according to the waves of the epidemic.points to the Drees. The temporary deployment of beds to deal with the pandemic is therefore not included in this year-end inventory.Therefore the service cannot provide data on the number of beds open on average throughout 2020.

Highly anticipated, the data on hospital reception capacities at the end of 2021 will be revealed by the statistics department at the end of September. But many professionals interviewed were pessimistic. “The closing of the bed continues, says emergency doctor Christophe Prudhomme, delegate of the national CGT Healthbecause the planned restructuring of operations, which has been accelerated by successive Ministers of Health, is always based on the same logic: when you renovate a hospital, there must be at least a 20% cut in the bed, which has not changed.“. And this, despite the health crisis.

For his part, Rémi Salomon considers it difficult to estimate the evolution of the hospital’s reception capacities in two years. However, according to the president of the Conference of Presidents of Establishment Medical Commissions (CME) of the CHU, the beds that have closed in recent months “not by choice, but by lack of personnel“. An end where many hospitals were forced this summer, in Bordeaux, Besançon, Rennes, Vierzon, Dijon or even Poitiers. About the closurestremor“in beds,”the majority is due to the evolution of care methods, to continue more ambulatory“, we say at the FHF, saying that it has no more recent figures than DREES. There is no doubt that the next publication on this topic will be closely scrutinized, including by political actors.

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