Public hospitals hospitalize more than private ones. Another influencing factor: the state of health of the patients. The most fragile are more often kept in a department.
One in five emergency room visits result in hospitalization. But this average hides strong imbalances between the different types of establishment. Thus, the public sector hospitalizes more than the private one. This is what a study of the Directorate of Research, Studies, Evaluation and Statistics (Drees), released February 28. Compared to a hospital center, the probability of admission to the services of lucrative private establishments is reduced by 30%.
Symptoms on the front line
This discrepancy is undoubtedly explained by “the differences between the patient population of public establishments and that of private establishments, both from a medical or social point of view and from the choice of resorting to emergencies,” explains Drees. The authors of this study also suggest that, in the private sector, access is rather directly done in a particular service.
In fact, other factors influence the risk of hospitalization more strongly, starting with the patient’s state of health. Fever, intoxication, psychiatric motive: these are the affections which favor the passage in a service for the night. Thus, three quarters of patients who complain of weakness in a limb are kept for observation. This is a “symptom that could be reminiscent of a stroke,” says Drees.
Likewise, two thirds of people with breathing difficulties spend the night in a hospital ward. Conversely, trauma or ENT symptoms are less prone to hospitalization.
Fragile patients
It is the patient’s fragility that is taken into account in the decision to move the file to another service: these transfers are more frequent in people brought to the emergency room by the SAMU, but also in elderly patients. 50% of those over 75 do not return home immediately. People hospitalized in institutions are also more hospitalized, no doubt because it is a factor of fragility.
But another factor weighs heavily in the choice of emergency physicians: the distance from home. “Doctors take into account, in a given state of health, the risks inherent in a longer trip between the home and the emergency room and prefer to keep the patient in the hospital”, specify the authors of the study. Situations that offer few alternatives to hospitalization then more often lead to hospitalization. This is the case for people who live alone or passing foreigners.
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