How many are they ? 20%? 30 % ? The percentages come up regularly in the mouths of doctors and public decision-makers to evoke the share of patients who would go to the emergency room without really needing it. Either this “bobology” sometimes referred to by emergency physicians, including all those people who could be taken care of elsewhere given their condition.
How many are they, then? The question has resonated more strongly in recent weeks, as many hospitals face unprecedented tensions. At least 120 emergency services have been facing great difficulties since the end of May, according to the SAMU-Urgences de France union, with some having to close at night or on weekends due to lack of sufficient staff. Among the government’s responses to try to lower the pressure is entry regulation, mainly by the SAMU, in order to filter out “real” emergencies and redirect others.
To find out about the profile of the patients who come today to this ” front door “ of the hospital, there is no single indicator or which would make the unanimity to know how many can be ruled out without risk. Reports have been piling up on the subject for decades, while emergency room attendance has continued to explode. From around 10 million in 1996, the number of annual visits there reached 21 million in 2019, according to the latest statistical data, in the 629 health establishments with emergency services.
The proportion of patients in the most severe states has changed little, if at all, over the years, according to the report by Doctor Jean-Yves Grall, in 2015, on the territorialization of emergency activities. The “serious cases” represent approximately 10% of admissions, half of which are life-threatening emergencies. “It is not so much the management of “real emergencies” that poses a problem and causes crowds as the requests for unscheduled care, the nature of which is varied, based on various situations (chronic illnesses, elderly people, psychological or social distress, various feelings…)”he wrote.
A lack of alternatives
Measure and analyze “avoidable passages” seems a ” major issue ” to the Court of Auditors, which mentions the subject in its 2019 annual report, where it is concerned to see the emergency services “always overstretched”. As much for medical as financial reasons, judges the institution, which quantifies the cost of the annual passages to 3.1 billion euros.
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