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Évolution sur le long terme des activités et des masses financières des centres hospitaliers spécialisés Volume 83, issue 7, Septembre 2007

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Authors
Université de Rennes 1, Campus des Sciences, ENSP, Laboratoire LAPSS

Long term evolution in the activities and financial movements of specialised hospitalsA comparative analysis was carried out into the evolution in the activities and budgets of French psychiatric hospitals between 1980 and 2004. A reduction in the number of beds, and consequently in the number of days, was accompanied paradoxically by an increase in the number of admissions, but a drop in the average length of stay. The “turnover” rate increased six-fold, transforming the nature of medical work by increasing indirect peripheral tasks involving incoming patients (flow control, reception, admissions) and outgoing patients (liaison, orientation). This increase, greater than the reduction in direct tasks caused by the drop in the number of patients present per carer, is probably partly responsible for current staff dissatisfaction. Hospital budgets did not diminish proportionally to the decrease in the number of days, possibly because of the development of other forms of hospitalisation and extramural work. Medicotechnical and technical staff saw their numbers go down in a context of overall relative stagnation in staff numbers until a slight increase recently (RTT)