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The current crisis in public hospitals: 1/ A practitioner’s perspective

Par : Type de matériel : TexteTexteLangue : français Détails de publication : 2023. Sujet(s) : Ressources en ligne : Abrégé : Hospitals have been in crisis for over ten years. Their budgets have been constrained by the combination of T2A (activity-based pricing) and the ONDAM. Staff numbers, which account for two-thirds of hospital budgets, have been subject to pressure. With fixed costs rising faster than their budgets, hospitals have cut back on capital expenditure. Working conditions and patient care have deteriorated. With shorter lengths of stay for patients, increased workloads for caregivers, and the need for multi-skilling and flexibility, hospitals have become less attractive. Until 2018, beds were being closed to reduce staff costs. In 2023, beds are being closed due to lack of staff. The hospital crisis is exacerbated by the lack of territorial coverage and the weakness of prevention policies. The amount of available nursing time is steadily decreasing, increasing the burden on the remaining staff. A more considerate organization, respectful of professional skills and attentive to the demands of caregivers and patients, should be the basis for how we operate. The regulation of hospital expenditure must cease to be a matter of accounting, independent of increasing needs and costs. It must be regulated a posteriori, based on prescriptions and procedures. This requires the implementation of a policy involving all health care-system stakeholders in the decision-making process.
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Hospitals have been in crisis for over ten years. Their budgets have been constrained by the combination of T2A (activity-based pricing) and the ONDAM. Staff numbers, which account for two-thirds of hospital budgets, have been subject to pressure. With fixed costs rising faster than their budgets, hospitals have cut back on capital expenditure. Working conditions and patient care have deteriorated. With shorter lengths of stay for patients, increased workloads for caregivers, and the need for multi-skilling and flexibility, hospitals have become less attractive. Until 2018, beds were being closed to reduce staff costs. In 2023, beds are being closed due to lack of staff. The hospital crisis is exacerbated by the lack of territorial coverage and the weakness of prevention policies. The amount of available nursing time is steadily decreasing, increasing the burden on the remaining staff. A more considerate organization, respectful of professional skills and attentive to the demands of caregivers and patients, should be the basis for how we operate. The regulation of hospital expenditure must cease to be a matter of accounting, independent of increasing needs and costs. It must be regulated a posteriori, based on prescriptions and procedures. This requires the implementation of a policy involving all health care-system stakeholders in the decision-making process.

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