“Helping the hospital by shifting the center of gravity of our healthcare system to the home”

DFrom Athens to Stockholm, from Lisbon to London, the international picture of health systems is worrying. If we take a step back, the observation is clear: populations are aging and require more and more care. Health expenditure is now changing faster than the gross domestic product, and public and/or private insurers everywhere are putting pressure on providers – city professionals and health establishments – to make them achieve productivity gains, and ultimately savings to ensure their sustainability.

The growth in the demand for care is de facto associated with the search for productivity gains. The latter results for caregivers in reducing the time devoted to the relationship with the patient, which is at the heart of their professional vocation. This is the main cause of the crisis of meaning of health professionals in France and in all Western countries.

Read our editorial: A transparent debate to save the public hospital

Thus, the World Health Organization continues to warn about the worrying prospects of vacant jobs for health professionals by 2030. This vocations crisis preceded the Covid health crisis, but the latter has amplified. There is now a contradiction as paradoxical as it is worrying between the acceleration of medical progress – an element of considerable progress – and the deterioration of the conditions of exercise of professionals. For example, health innovation makes it possible, thanks to immunotherapy treatments (billed on average 400,000 euros per patient to Medicare), to transform a cancer that was still very aggressive yesterday into a chronic disease.

In view of this medical and scientific prowess, the same cutting-edge hospitals that offer these treatments to the entire population are suffering, for example, from an impoverishment of their information systems, which are currently lagging behind the digital revolution, with consequences for the work ergonomics for professionals.

Health professions, which were among the most sought after in our societies throughout the 20the century, will they be professions gradually neglected in the 21ste century ? Faced with this historical trap, the leaders of the health system today have the ethical responsibility of being, in turn, a source of proposals with regard to professionals, patients and public authorities.

New winning equation

In this unfortunately fairly homogeneous international picture, our country nevertheless suffers from a specificity. For more than twenty years, the first line of care has been unable to cope with the aging of the population and the growing burden of chronic diseases. In a generation, the hospital has seen its core business expand constantly, to the point of taking on activities that should not be its own. He has become the handyman of the health system, which in turn leads the community to ask him for new productivity gains…

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