[Crisis at the hospital and the hospice, same combat: Break down the walls!]

Sante Publique. 2019 Marc-Apr;31(2):293-295. doi: 10.3917/spub.192.0293.
[Article in French]

Abstract

The crisis in public hospitals and accommodation facilities for the elderly (EHPAD) focuses on issues of governance and internal resources (including financial ones), while the responses should be found in an organized and consolidated fluidity between the world of hospital or medico-social institutions and the usual living spaces of the population. At the hospital level, the main difficulties are due to a regularly announced, but incomplete, transfer between the activities of these institutions and outpatient medicine. The solution is certainly in a single governance of health policy, currently shared between the state and health insurance. For the EHPAD, the institutionalization of frail elderly people and/or those in the process of dependence, as well as the unsuccessful proliferation of multiple experiments in their care at home, lead, on one hand, to an increasingly complex offer, not understandable for everyone, and secondly, to rely mainly on the general practitioner for the coordination of this care. The solution is certainly in a universal offer, under common law, which would allow the elderly population to stay as long as possible at home, which is what they wish the most.

MeSH terms

  • Aged
  • Health Policy*
  • Health Services Needs and Demand
  • Hospices*
  • Humans