At the hospital, still fewer full hospital beds

Where are the reception capacities of the hospital, at a time when the Covid-19 is once again circulating at a high level in France? This Wednesday, the State published the count of the various beds in French establishments for the year 2021. First observation: if the Omicron variant and the vaccine drastically reduced the number of serious cases, in 2021, the hospital maintained a strong mobilization in intensive care. In addition, the shift towards ambulatory care undertaken under the previous five-year terms, which consists of closing overnight beds to open partial hospital beds, day or at home, has continued despite the health crisis.

According to the latest report from the Statistical Department of Social Ministries (DREES), intensive care reception capacities remained 10.2% higher in 2021 compared to the end of 2019. As of December 31, the establishments of healthcare had 20,070 critical care beds: this is 240 less than at the end of 2020 (-1.2%), but 470 more than at the end of 2019 (2.4%), before the outbreak of the epidemic.

Fewer beds for more patients? More than 4,300 full hospital beds were closed in 2021 in French health establishments, according to Drees. "The number of full hospital beds fell at a fairly steady pace before the health crisis (-0.9% per year on average from 2013 to 2019). The drop is -1.1% in 2021, after - 1.2% in 2020", details the organization.

In addition to the Covid-19 epidemic which again led, last year, to the closure of services and double rooms, hospital capacities suffered from "staff constraints that did not allow the beds to be maintained", explains the 'public body. As of December 31, the 2,984 public and private hospitals had 382,587 full hospitalization beds, ie 4,316 less in one year.

Above all, the hospital continues its "ambulatory shift [...]. For twenty years, the organization of the care offer has evolved towards a significant increase in the number of places for partial hospitalization (without overnight stay) and hospitalization at home, in view of a continuous reduction in the capacity for complete hospitalization (beds)", recalls the organization.

In 2021, 2,700 partial hospitalization places have been created. The number of “day” hospital places has also continued to rise: 2,743 were opened in 2021, bringing their total to 82,502, i.e. 9,000 more in five years. Hospitalization at home also recorded a clear increase in its capacity, by 6.8% after a jump of more than 10% in 2020. With 22,800 patients "able to be cared for simultaneously on the territory", this now represents "7.6% of total capacity in full hospitalization" excluding psychiatry, against 2.1% in 2006.

In total, more than 21,000 beds were eliminated between the end of 2016 and 2021, corresponding for the most part to Emmanuel Macron's first five-year term. That is twice as much as under his predecessor François Hollande (- 10,000), but significantly less than during Nicolas Sarkozy's mandate (- 37,000).