000			02004cam a2200205 4500500
005			20250121141530.0
041			_afre
042			_adc
100	1	0	_aGervais, Anne _eauthor
245	0	0	_aThe current crisis in public hospitals: 1/ A practitioner’s perspective
260			_c2023.
500			_a34
520			_aHospitals 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.
690			_ahospital
690			_amanagement
690			_afinancing
690			_aT2A
786	0		_nLes Tribunes de la santé | o 76 | 2 | 2023-06-23 | p. 23-31 | 1765-8888
856	4	1	_uhttps://shs.cairn.info/journal-les-tribunes-de-la-sante-2023-2-page-23?lang=en&redirect-ssocas=7080
999			_c582490 _d582490