For magistrates, who made a report on Monday, “the domicilarity often announced” is “still not successful” because of insufficient offer and not structured enough.
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Aging at home is the wish of the French but remains a dream inaccessible for a lot of lack of a sufficient home care offer, responsive to the Court of Auditors in a report made on Monday, January 24th. Despite the commitments of successive governments since 2005, “the domicile turn often announced” is “still not successful”, highlight the financial magistrates, which investigated home care at the request of the Senate Social Affairs Committee.
France has only 2,125 home nursing structures that can deal with 126,600 potential beneficiaries. Either 20 places for 1,000 people aged 75 and over, compared to 102 EHPAD places for 1,000.
If only to maintain this offer of care at the same level as today, the Court considers the needs of 25,000 new places by 2030, to deal with the demographic shock. The report also reviews structures for people with disabilities.
No data study
To create places, a home nursing service (SSIAD) must have the green light of a regional health agency (ARS). Until 2015, “great national plans have increased significantly the offer”, which has been followed by a “net slowing of places creations”. So that the institutionalization rate of the elderly, that is, the proportion of people residing in EHPAD in the population, has remained the same. More than 80% of places in the medico-social sector are in EHPAD.
This “wait-like” pinned by the report holds a reform “great age” always repulsed. And stems from the delay taken on several projects. The first concerns the deepening of the data on “poorly known services”, underlines the report: “To date, there is no needs analysis that allows to plan an adjusted offer” home care.
The reproach is for the National Health Insurance Fund (CNAM), which has still not exploited the information on the health expenditure of the elderly institutions, at the hospital or at home, Since 2019, it has been able to “measure the performance of medico-social support” and “guide care more efficiently”, regrets the Court, which recommends the dissemination of this information from the CNAM at central governments responsible for developing programming, LRAs and all SSIAD financial managers.
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