In France, some hospitalizations are avoidable. In any case, this is what a study by the Department of Research, Studies, Evaluation and Statistics (Drees) suggests, published this Thursday, April 6. According to the public administration, under the supervision of the Ministry of Health and the Ministry of Economy and Finance, one out of forty hospitalizations could be avoided, provided that patient care is improved upstream, particularly in city.
“In 2017, 265,000 hospitalizations for chronic pathologies could have been avoided”, specifies the DREES, whose study focuses on data from that year. These potentially avoidable hospitalizations (known as HPE) frequently affect the same patients. “26% of the people concerned in 2017 had already experienced an event of this type during the previous five years and 14% experienced several HPE this same year”, details the DREES in its score report.
Older people most affected
In its study, the public administration also draws up the profile of the patients most affected by these potentially avoidable hospitalizations. They particularly affect older people. In 2017, four out of five affected people were 65 or older, and one in three were 85 or older. “This high proportion of elderly people among patients who experienced HPE is linked to the increase in hospitalizations with age,” the document states. Especially since certain chronic pathologies affect older people more, and the study indicates precisely that patients with these pathologies are also the most affected by these HPE. “Among people aged 65 to 84, men have a 64% higher risk than women of having HPE”, notes the study without, however, giving the reasons.
Nearly half were due to heart failure. “The number of HPE for heart failure increases sharply with age,” says Dress. Dehydration (11%), angina pectoris (8%) and asthma attacks (6%) are also particularly part of the reasons for these hospitalizations.
The translation of poor patient follow-up
Another highlight of the study: the risk of potentially avoidable hospitalization decreases with the level of diploma. Compared to employees, manual workers have a 43% higher risk of being hospitalized in an avoidable way. While farmer operators also have a 38% higher risk than employees. “Working conditions and exposure to hardship factors of these socio-professional categories during their working life could influence their state of health in retirement and therefore the probability of having HPE”, indicates the report. “Other mechanisms, of a socio-cultural nature, are likely to play an upstream role in follow-up in the city: relationship to the body and to the health of one’s socio-professional environment, social distance with the doctor…”
In addition, the DREES indicates that these potentially avoidable hospitalizations are to be distinguished from irrelevant remedies. That is to say patients who go to the hospital when they could have consulted a general practitioner for example. “When it takes place, the HPE is necessary, but if the patient had been better taken care of upstream, the risk of hospitalization could have been reduced”, points out the administration. In other words, a low rate of HPE within a territory suggests good follow-up of patients on an outpatient basis, making it possible to dispense with costly hospitalizations for the patient as well as for the health system. However, between 2012 and 2017, the number of potentially avoidable hospitalizations remained stable.