A new report shows the number of occupied hospital beds has fallen by more than 10% in 10 years

More than 43,000 hospital beds across France have closed for inpatient care in the last 10 years, with staff shortages and changes in care plans the main reasons for this, a new report has found.

The number of beds available for full hospitalization has fallen by 43,500 since the end of 2013 (a 10.5 percent decline over 10 years) and is down 1.3 percent in 2023 alone, following a 1.8 percent decline in 2022. a new report by the national statistics and research organization DREES (Direction de la recherche, des études, de l’évaluation et des statistiques).

The report shows that as of December 31, 2023, 369,423 beds were available for full hospital care in France’s 2,962 hospital establishments (public, private or non-profit).

Also read: Why did France lose 80,000 hospital beds in 20 years?

Changes in care plans

An important reason for the decrease in the number of hospital beds is the so-called bend ambulatoire (‘ambulatory shift’) policy was introduced in the early 2010s. This was a policy aimed at reducing the rate of hospitalization of patients altogether where necessary or possible, in part to reduce social security costs and also due to advances in surgery and anesthesia.

But personnel issues over the past few years have also contributed. The Fédération Hospitalière de France states that 99% of public sector organizations face staff shortage problems in 2022, with 6.6% of vacant nursing positions remaining vacant in the same year.

Also read: Hospital beds ‘closed’ in France due to lack of workers

Partial hospitalizations are increasing

The number of full hospitalization beds may be declining, but the number of partial hospitalization beds (usually meaning hospitalization without an overnight stay) appears to have increased steadily since 2013, the report found.

A total of 20,900 places were created, an increase of 31% in 10 years. These places have also increased since the Covid crisis. Partial places increased by 4.1% in 2023, compared to 3.1% in 2022 and 3.4% in 2021.

There were 88,504 partial hospitalizations nationwide, the report said. Unlike overnight beds, these beds can be used by multiple patients per day as they are admitted, treated, and discharged.

home care

Another alternative that is increasingly offered is hospitalization at residence (HAD, hospital treatment at home) allows some care to be carried out in the patient’s home, such as some types of chemotherapy, palliative care and rehabilitation treatments. This aims to reduce overcrowding in hospitals and also ensure that patients remain in the comfort of a familiar environment during treatment.

HAD has skyrocketed during Covid (up 12.9% in 2020) as a way to reduce overcrowding and improve patient safety. HAD care increased by 4.1% in 2023, and by the end of the year the capacity of patients who could be treated simultaneously under the HAD program increased from 18,900 pre-Covid to 24,100.

Home hospitalization now represents 7.7% of total treatment capacity, which would otherwise be a short or medium-term patient stay (excluding psychiatry).

Despite these changes, there is still a large shortage in the availability of hospital beds. There are 10,500 fewer hospital places in total in France compared to 2013, although there are 20,900 partial hospital places created in 10 years and around 12,100 more HAD places.

The number of available places in intensive care is now 0.9% below pre-Covid levels, with 310 fewer intensive care beds and 200 fewer inpatient beds than in 2019.