HBI Deals+Insights / HR, Culture and Training

Medical staff spending vs hospitalisation rates

This week we plot medical staff spending in France against total hospitalisation rates and explore how the numbers paint a picture of national sectors. What treatments cost businesses and payors the most in staff resources? Where are inpatient admissions the highest?

The highest spend on staff out of a list of 27 different conditions and illnesses, ranging from cancer to Parkinson’s disease, is on nurses employed to care for patients with dementia. This likely reflects the higher proportion of spending on home care, where independent nurses or infirmièrse libérales are contracted for HAD (hospitalisation at home) and SAD (care at home) patients.

Yet hospitalisation numbers for such patients remain relatively high. We hear there is a real need for medicalised nursing homes, so much so that facilities are increasingly having to treat patients with specialist needs without the skills or training to do so. Could a better spread of adequately trained staff in increasingly specialist settings free up hospital beds?

Click on the three dots on the right of the image below to see the graph full-screen

The highest level of hospitalisation is for patients with psychiatric disorders. An interesting exercise would be to compare these figures to the UK, where care in the community has been the push for decades. The high figures reflect the prevalence of inpatient treatment in France, though we hear from Orpea’s psychiatric, mental health and rehabilitation arm Clinea that the sector is moving towards outpatient and digitalised care pathways – though spend on staff seems on the low side, especially for a sector with high levels of inpatient care.

The last spike in hospitalisation numbers on the graph is for chronic dialysis patients. This likely reflects the standard opt-in to hospital-based haemodialysis as opposed to peritoneal which can be administered at home, though the latter is seen as a growth market for many medicalised homecare providers on the French market.

The graph also raises some questions. Though we can’t tell what settings the doctors and nurses are treating patients in, it’s hard not to wonder whether low spend on nurses for patients with diabetes doesn’t reflect lower levels of home care. Would hospitalisation rates drop if spending on nurses in a home care setting increased? Would the same apply to chronic respiratory diseases?

We would welcome your thoughts on this story. Email your views to Anaïs Charles or call 0207 183 3779.