The elderly residing in Lozère are not housed in the same boat as the inhabitants of Corsica when it comes to finding a place in an nursing home, and at a price that is not prohibitive. A UFC study-What to choose published on Tuesday May 17 denounces“intolerable geographical and economic disparities” in terms of available places and prices in establishments.
The number of places reported to the population of people over 75 can thus vary from simple to fourfold depending on the departments, underlines the consumer association. While throughout the national territory, the average number of places is 102 per 1,000 inhabitants over the age of 75, this figure reaches 169 in Lozère and drops to 41 in Paris. In the departments of south-eastern France or Nouvelle-Aquitaine, the number of places is less than 50 per 1,000 elderly inhabitants.
By narrowing its analysis to only very dependent people – those with a level of dependence corresponding to GIR (for iso-resource group) of 1 or 2 out of 6 – the UFC-Que Choisir highlights the same disparities: in Mayenne, they “benefit in 90% of cases from a place in nursing home, when this rate drops drastically to 42% in the Gard, and even to only 38% in Corsica”denounces the study.
Average prices that vary from simple to double
This geographical divide is coupled with considerable economic inequalities depending on the territory. The average cost of an Ehpad in France – 2,214 euros per month – masks significant disparities. In the Meuse, the average price of a room in an nursing home is 1,749 euros per month; in Paris, the monthly cost of this type of accommodation rises to 3,698 euros. In the Rhône, Bouches-du-Rhône, Corse-du-Sud and in the Alpes-Maritimes, it varies between 2,521 euros and 2,679 euros per month. Conversely, this financial burden is less than 2,000 euros in 31 departments, mainly in the center of the country.
However, these price differences are largely explained by the relative weight, in each department, of public, associative or private nursing homes for commercial purposes. “Private nursing homes are sometimes overrepresented in certain departments”and the higher their share “the higher the average price of a place is”, analyzes the association. In the Bouches-du-Rhône, for example, one of the territories with the Alpes-Maritimes and the departments of Ile-de-France, where the average price of a place in nursing home is the highest, nearly 64 % of places are offered by private establishments.
Private nursing homes cost on average 50% more than public structures. In 22 French departments, including Paris, Ile-et-Vilaine, Hauts-de-Seine, Loire-Atlantique, Yvelines, Haute-Savoie, Isère, Savoie and Maine-et-Loire, the price of a place in a private structure is on average 1,000 euros higher than that of accommodation in a public Ehpad.
A higher rate of supervision in the public
“Everything suggests that turning to the high cost of the private sector is sometimes imposed by an impossibility of being able to quickly enter a public establishment”, writes UFC-Que Choisir. These higher prices are not, however, a guarantee of a better quality of care and service, regrets the association. She recalls that the rate of supervision of residents is only 55.6% in the private sector against 68.1% in the public sector.
The study denounces a “profit maximization strategy of private establishments”which does not always take into account the well-being of residents, implementation “with the implicit and deplorable blank check of the public authorities”. The latter promote their development, in particular because their residents are less often eligible for social assistance, says UFC-Que Choisir. Between 1997 and 2020, the market share of private structures increased from 14% to 23%.
In a context of an aging population, the association urges that “the creation of new places in nursing homes is mainly done in public structures”, so that each dependent elderly person who wishes can find a place “at a reasonable price”. Private establishments should see their prices capped, and be forced to offer places eligible for social assistance. Finally, recommends the UFC-Que Choisir, a “compulsory minimum supervision rate” should be imposed on all establishments.