Europe 1 with AFP / Photo credits: Nicolas TUCAT / AFP 3:40 p.m., March 18, 2024

According to a study by the French Hospital Federation (FHF), hospital activity restarted in 2023 but insufficiently for the most serious care, and a serious “public health debt persists”.

The level of activity of health establishments has generally returned in 2023 to the level observed in 2019, even if disparities remain.

Hospital activity restarted in 2023 but insufficiently for the most serious care, and a serious “public health debt persists”, some 3.5 million hospital stays having not been able to be carried out since the Covid epidemic. 19, according to a study by the FHF.

According to this "first barometer" from the French Hospital Federation (FHF, public hospitals) published Monday, which is based on national data concerning public and private, the level of activity of health establishments has generally returned in 2023 to the level observed in 2019.

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But behind this recovery "hide worrying disparities which should question the public authorities", launched the president of the FHF Arnaud Robinet during a press conference.

“We are worried”: major surgeries, transplants and the most complex medical activities, mainly carried out by the public sector, “are well below the expected level”, he said.

The hospital is also struggling to catch up on certain surgical activities.

In medicine, the FHF observes “under-use” (compared to 2019 activity) in digestive care (-11%), cardiology (-13%), the nervous system (-11%) or rheumatology (-12%).

It focuses almost exclusively on patients over 45, according to this barometer, produced in partnership with Radio France.

“This involves risks” for patients, in particular “delays in the detection of certain cancers”, specified Arnaud Robinet.

Diagnostic digestive endoscopies thus "fallen markedly" in 2020 and insufficiently restarted, which could, according to the FHF, explain the lower than expected number of "major digestive surgeries" (-7% compared to the expected level), performed for a lot in case of cancer.

In diabetology too, the drop in care since 2020 “coincided with an increase in activity” for complications linked to diabetes, underlines the FHF.

The hospital is also struggling to catch up on certain surgical activities, such as transplants (-7.5%).

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The two main “hypotheses” to explain this situation

The FHF puts forward two main “hypotheses” to explain this situation: persistent tensions on hospital capacities and a probable increase in forgoing care.

According to a survey carried out in March 2024 in 45% of public hospitals, the equivalent of 7% of hospital beds in medicine, surgery and obstetrics were occasionally closed in 2023, in six out of ten cases due to a lack of caregivers.

“There is an emergency”, and the government, which must set in the coming days the new reimbursed rates for hospital services, must “support the public hospital” by “concentrating resources” on these priority sectors, argued Arnaud Robinet.

According to an IPSOS survey (February 29-March 6, among 1,500 people), 63% of French people have given up on at least one healthcare procedure over the last five years, particularly due to delays in obtaining an appointment (53 % of cases) or for financial difficulties (42%).

The survey shows an increase in delays and significant territorial inequalities.

In rural areas, respondents report having an average travel time of 57 minutes to consult an ENT, 50 minutes to see a pediatrician, compared to 32 and 31 minutes respectively in urban areas.