Ambulatory surgery, does it stagnate:: This article explores the topic in depth.
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Ambulatory surgery. Meanwhile, does it stagnate::
Ambulatory surgery has been anchored for years in the health landscape, but the practice remains below the national objectives set, according to the Tool Visuch-maladie which makes it possible to explore the surgical data of professionals and health establishments interactively.
In fact. Moreover, despite the progress made, the rise in recent load is deemed too slow, according to the latest report called “charges and products” of the CNAM, reference document on the savings and revenues of health insurance which guides the government for the preparation of the social security budget (PLFSS). Consequently, “Although as a constant increase since 2013 (…). Furthermore, the rate of ambulatory surgery calculated from the Visuichir tool could have risen to 82 %”, While it stagnates today 64 %, regrets the report. Similarly, The observation is therefore mixed: after a good dynamic noted in the ambulatory surgery, does it stagnate: previous decade (+20 points between 2010. Therefore, 2020), ambulatory surgery clearly marks the plunge. Similarly, To the point that the CNAM claims to trigger. Consequently, succeed in “Second wave” To reach the famous target of 80 %, with a “Operational plan”.
18 Marquer gestures – Ambulatory surgery, does it stagnate:
Initially targeted on 18 marching gestures identified by the International Company of Ambulatory Surgery from 2003. In addition, ambulatory surgery gradually extended to all acts and specialties. For example, The national rate of ambulatory surgery identified by Vischir exceeded 60 % in the early 2020s (with an average. annual increase of 2 to 2.5 points), before experiencing a more jerky development and worrying stagnation. “For 2023, this is the lowest annual increase in fifteen years, excluding Covid, with a national ambulatory rate of 63.7 %. Even if ambulatory surgery has exceeded 4 million stays, its rate has increased by less than ambulatory surgery, does it stagnate: one point. France presents sometimes low ambulatory surgery levels on certain surgeries compared to our neighbors ”specifies the charges and products report.
At the current rate of ambulatory increase. it will be necessary to wait 2043 to reach the target rate of 80 %
Letter Visuchir, July 2025.
While the rate stagnates around 64 % in 2024, the letter visuir published by the CNAM in July drives the nail. “At the current rate of progression. it will be necessary to wait 2043 to reach the target rate of 80 % and 2046 to reach that of visuiring (82 %), or 1.28 million conventional transferable stays”, Can we read. This outpatient (ideal) potential is calculated ambulatory surgery, does it stagnate: from 20 % of the best French ambulatory practices observed in 2024.
Clinics, best students
In detail of health establishments, private clinics manage to do well. Thus. the first 40 French establishments in ambulatory surgical volume are clinics, except two CHUs, a CH and an ESPIC (non -profit private). The private sector supports 65 % of total ambulatory surgery with very strong segments (cataracts, arthroscopy, etc.), confirms the last panorama of health establishments (2025 edition).
According to Vischir, private clinics display a national rate of ambulatory surgery of 74.2 %in 2024, fairly close to the target of 80 %, ahead of the ESPIC (65.1 %) then the cancer control centers (57.2 %). Hospital centers and CHR/CHUs that support 2.37 million surgical stays have a global rate of 48.3 %, with an outpatient transfer potential estimated at 597,000 stays.
Various brakes
Human resources which are lacking. lack of support for teams, unsuitable premises, difficulties in modifying practices or reorganizing: various reasons may explain the difficulties noted in changing brackets in terms of ambulatory surgery.
At the Rethel-Vouziers hospital center. the ambulatory surgery activity only resumed since July 21, the lack of hygiene in the operating room having been pointed out by the ARS in early July. The agency also deplored the lack of anesthesiologists and reporting defects after adverse events. Additionally, The South Ardennes hospital group (GHSA) has provided guarantees, including one “Support mission” contact details by a CHU doctor. The hospital is also committed to setting up monthly random checks within the block, transmitted to ARS.
82 %is a bad message. This punitive figure is not relevant. not tenable and annoys everyone
Pr Karine Nouette-Gaulain, president of AFCA
The question also arises of the disconnection between certain objectives set by the guardianships and the realities of the terrain experienced by the surgical teams. When the CNAM. based on its Visuchir tool, says that the outpatient potential rate could exceed 82 %, based on the 20 French best practices, the discourse is sometimes counterproductive. “82 %is a bad message. This punitive figure is not relevant. not tenable and annoys everyone ”tackle Professor Karine Nouette-Gaulain, anesthesiologist in Bordeaux, co-president of the French Association of Ambulatory Surgery (AFCA). Instead of fixing a uniform course. the president recommends instilling a new dynamic by mobilizing all the teams on the concrete interest of ambulatory surgery, including for liberal paramedicals who will take over as postoperatively.
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