As for intensive care units, the number of beds fell by 3.8% last year. It “remains however 10.2% higher than its level at the end of 2019, before the health crisis”, notes the DREES.
At the end of last year, during the presidential campaign, the government was questioned about the closures of hospital beds. It could be the same this year. According to the latest report from the DREES, published this Wednesday, around 4,400 full hospital beds were eliminated between the end of 2020 and the end of 2021, which represents a drop of 1.1%. Around 382,500 beds were thus counted at the end of 2021 in the approximately 3,000 health establishments in France.
This downward trend therefore continued last year. As in 2020 (-1.2%), it was a little higher than before the Covid-19 health crisis. Between 2013 and 2019, the average annual decline amounted to -0.9%. “Since the end of 2013, the cumulative decline has reached 30,000 full hospital beds, i.e. -7.3% in eight years“, notes the statistical service of the Ministry of Health.
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The coronavirus pandemic, which continued to put pressure on the hospital system last year, is no stranger to the drop in the number of beds observed in 2021, indicates the Drees. She mentions the “staff constraints“, who did not allow “to maintain the beds“, after caregivers were wrung out by the health crisis.
Continuation of the ambulatory shift
“Some establishments have thus been forced, temporarily, to no longer accept patients in several of their hospital departments in order to free up staff resources to be assigned to critical care departments.“, adds the statistical service. Finally, “the deprogramming of hospitalizations and the transformation of double rooms into single rooms to limit contagion have also reduced the number of beds able to accommodate patients“says the study.
The decline in the number of beds in 2021 also reflects the shift to ambulatory care in hospitals. “Over the past 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 of full hospitalization (beds)“, explains the DREES.
Thus, in parallel with the drop in the number of full hospitalization beds in 2021, the number of partial hospitalization places continued to increase. It even accelerated compared to the pre-Covid period: +3.4% in 2021 against +2.5% per year on average between the end of 2013 and the end of 2019. Enough to fully offset the slowdown in 2020 linked to the health crisis . “Since the end of 2013, 15,000 places have been created, an increase of 22.1% in eight years“, writes the Drees, to reach around 82,500.
Sheave capacities remain above their 2019 level
As for home hospitalization (HAD), its capacities grew more slowly in 2021 (+6.8%) than in 2020 (+10.5%), “to reach 22,800 patients who can be treated simultaneously in HAH on the territory“. At the end of 2021, hospitalization at home thus represented “7.6% of the total capacity for full hospitalization for short and medium stays (excluding psychiatry), compared to 2.1% in 2006“, reports the Drees.
Highly requested in 2020 and 2021 to care for patients with Covid-19, critical care reception capacities (resuscitation, intensive care and continuous monitoring) decreased at the end of 2021 (-1.2%). The DREES explains it by the evolution of the modes of care for these patients, “in particular with the arrival in the fall of the Omicron variant, making it possible to slightly reduce the need for critical care“. Despite this drop last year, the number of critical care beds remains above its pre-crisis level: health establishments had more than 20,000 beds at the end of 2021, i.e. 470 more than at the end of 2019.
Within critical care, the same observation applies to resuscitation, whose capacities exploded in 2020 under the effect of the Covid-19 crisis (+14.5%), to cope with the influx of sick. Although in 2021 the number of intensive care beds fell by 3.8%, “the total number of intensive care beds remains however 10.2% higher than its level at the end of 2019, before the health crisis“, underlines the statistical service of the Ministry of Health, which specifies that all these figures”are likely to be revised by the end of 2022“.