TRUE OR FALSE. Has attendance at emergency rooms doubled in twelve years, as stated by Minister for Health Frédéric Valletoux?

“Ten million visits to the emergency room a dozen years ago compared to 21 million today”, assures the minister who is wrong: attendance at the emergency room has doubled in almost thirty years, not in twelve years. But there is an undeniable increase.

Lucas, 25, was found dead after hours of waiting in the emergency room in Hyères (Var). Josiane, 66, died in the emergency corridors of Eaubonne hospital (Val d’Oise). Several families of patients have recently filed complaints for “failure to assist a person in danger”. “We can die in hospital, yes”conceded the Minister for Health, Friday February 16, Frédéric Valletoux, on franceinfo. “An investigation is underway, it will say, if there were any failures, where they came from.” “The emergency department is the public service that has seen its attendance double […]there were 10 million visits to the emergency room a dozen years ago, we are at more than 21 million today”, affirmed the Minister Delegate. True or false ?

Attendance at emergency rooms has doubled in almost thirty years, not in twelve years

This is false, Frédéric Valletoux is wrong in the figures. If we refer to data from Drees, the statistical service of the Ministry of Health, there were 18.7 million visits to the emergency room a dozen years ago, in 2012. Today, according to the latest figures published, in 2021, we are at 20.3 million visits to the emergency room. There were more than 21 million passages in 2019, before a drop due to covid. We are therefore far from a doubling. We have to go back to 1996 to find 10 million visits to the emergency room per year. In fact, emergency room attendance has doubled in almost 30 years, not in twelve years, as Frédéric Valletoux said.

But there is undeniably a constant increase in visits to emergency rooms, even though the number of structures has not increased at the same time. How can we explain this increase in attendance, observed in most developed countries? In a study published in 2015 and repeated in 2019 in a report by the Court of Auditors, the OECD puts forward two main reasons to explain this: an increase in demand and a change in supply.

Some patients prefer to go to the emergency room, others have no choice

On the one hand, patient behavior has changed: they prefer to go to the emergency room to have all possible specialists and examinations available in one place. In a report from the Senate Social Affairs Committee, published in 2017, elected officials speak of a “societal development promoting immediacy of access to care”. In a large survey conducted in 2013 by Drees, six out of ten patients even said they had come to the emergency room because of “accessibility” and in particular for “resolve the problem quickly”. Furthermore, another factor is influencing demand: the aging of the population.

On the other hand, the care offer is evolving: “evolution of medical practices with more systematic complementary examinations, increasing absence of doctors working outside office opening hours”, writes the Court of Auditors in its report. The lack of town doctors in certain places or at certain times forces patients to turn to the emergency room. In its survey, Drees notes that two out of ten patients came to the emergency room because “the treating doctor is absent or due to the impossibility of finding a doctor in the office”.

Half of patients in France receive first aid within half an hour

We also often hear about bobology, the fact of coming to the emergency room when there is no emergency, but this actually represents a minority of patients. The phenomenon is difficult to quantify, recognizes the Court of Auditors. Based on the clinical classification of emergency patients (CCMU), the Court of Auditors estimates “between 10 and 20%” the number of patients concerned. But this figure should be taken with a grain of salt: it is based on the cases identified after a consultation by the emergency doctor. However, the patient could indeed initially present worrying symptoms, which justified his visit to the emergency room.

With all this, how much is the waiting time in the emergency room before being treated? According to the Drees survey, half of patients in France receive first aid within half an hour, and seven out of ten patients within the hour. This is an average for the entire territory. In Île-de-France, for example, delays are longer. We also wait longer during the day than in the middle of the night.