The government has made the development of outpatient surgery a major focus of its strategy to reduce the security gap. In this context, surgeons make proposals.
The health sector should achieve savings of 3.2 billion euros in 2015. The measures were detailed by the ministers of Health Marisol Touraine and Budget Christian Eckert, during the presentation of the Social Security budget for 2015. Among the measures, the government wants to limit hospital spending by pooling hospital purchases between establishments, “where very significant margins remain. ”
Thus, the reorientation towards outpatient care (outside the hospital) and the reduction of hospital inadequacies (beds occupied in an irrelevant and unjustified manner) should make it possible to save 1.5 billion euros.
However, while the government has made the development of outpatient surgery one of the “axes” of its “national health strategy”, this has fallen behind.
Less than one in two hospital stays
“There is awareness, we understood that this would reduce costs and we are now asking hospitals to do it but they are not used to it and it is slow to start”, explains Pr Corinne. Vons, surgeon at the Jean-Verdier hospital (Seine-Saint-Denis) who chairs the French Association for Ambulatory Surgery (AFCA). Asked by Agence France Presse, this pioneer of the practice underlines that the “revolution” of the outpatient clinic has landed in France years behind the United States and Great Britain. There, seven to eight out of ten operations are done in this way.
In France, in 2013, 43% of hospital stays were made on an outpatient basis: one in two in the private sector and one in three in the public.
Reduce the risk of nosocomial infections
The number of outpatient stays has nevertheless jumped by 38% between 2007 and 2013. Good news for health savings, but also for the French because surveys of patients operated by outpatient surgery for breast cancer have confirmed a level of ” very high satisfaction ”, reveals to AFP Hélène Esperou, quality doctor of Unicancer, a federation of 20 French anti-cancer centers.
Faced with these positive results, these establishments aim to perform half of outpatient breast cancer surgeries by 2020.
As a reminder, this technique can in particular be applied to surgery of the ovaries, the prostate, the thyroid, the digestive system, the lung or the joints which are areas where the ambulatory is already at work.
With real benefits for the health of patients because outpatient surgery reduces the risk of infections contracted in hospital (nosocomial). However, it cannot be applied to heavy operations.
The surgeons’ proposals
For its part, the French Society of Ambulatory Surgery (SFCA) thus proposed ten measures to develop and improve this practice in France, during a conference organized last week by the Union of Surgeons of France (UCDF).
These doctors propose to boost the sector by increasing their rates by 30%. “It seems reasonable to transfer part of the savings generated by the outpatient clinic, which benefit Health Insurance and complementary health insurance, to those who provide care, without whom nothing would be possible”, argues Dr Philippe Cuq, surgeon. vascular and president of the UCDF.
Finally, these specialists consider the restructuring of health establishments around outpatient practice necessary. The doctors of the SFCA therefore call for “innovating” in the way patients are received, especially in very remote areas, by creating “medicalized hotels” which are temporary upon return home, adjacent to establishments.
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