The interaction between the health system and the social organization is remembered, violently. In the foreground of the difficulties encountered by the health system are of course logic specific to the health field: the deleterious effects of years of Numerus Clausus, the shortages of staff and the overall organization of patient care – and In particular those in social difficulty – are as many issues as one cannot deny.
But these dynamics – in a way endogenous – should not hide equally powerful exogenous mechanisms. The epidemic of Covid-19 had shown those who have forgotten it that the state of health of a population, including in its most acute crises, and in the violence of mortality inequalities, was essentially linked to social determinants. Although no measure in direct time can quantify it, it is very likely that the unequal effects described on this occasion are still today at work. They multiply the risks for poor or modest people, weakened both by more frequent chronic diseases and more exhibiting living conditions – poor quality or over -occupied housing, forced transport and themselves degraded, impossibility of leaving precarious work -, and undoubtedly contribute, once again, to the development of epidemics and the flow of patients in emergency services or in medicine beds.
The situation of extreme tension experienced by hospitals also highlights another dimension of the reflections between the health system and the rest of the questions asked to the company.
blocked in beds
The week of Christmas in Ile-de-France-within a panel of twenty-two maternity-, forty-six women, including twelve speakers and thirty-four recently given birth, accompanied by newborns and sometimes The siblings were kept in the hospital for no medical reason, but for lack of downstream accommodation. If they vary from week to week, these figures are still high. The same week, very many patients were also blocked in hospital beds, while their condition only required nursing care, which is better suited to home. They were, for example, about seventy at the public assistance-hôpitaux in Paris, and seventy-quarters in the non-university hospitals of Seine-Saint-Denis. Again, it is the absence of accommodation or accommodation which won the hospitals and patients concerned.
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