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Surcharge du service des urgences : causes, conséquences et ébauches de solutions

Overcrowding in emergency departments: Causes, Consequences and Solutions

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Annales françaises de médecine d'urgence

Résumé

L’essor de la médecine d’urgence comme spécialité à part entière coïncide avec une augmentation de la fréquentation des services d’urgence, tant en France que dans le reste du monde. Il y a surcharge du service des urgences lorsque les capacités de celui-ci sont dépassées par le nombre de patients en attente d’être vu, d’évaluation, de traitement et de place d’hospitalisation. La surcharge des services d’urgence est associée à de nombreux effets indésirables, dont une augmentation des complications et de la mortalité. Cette surcharge, décrite tant en France que dans d’autres pays, est à l’origine d’une littérature grandissante depuis une dizaine d’années. Il est bien démontré que l’origine de cette surcharge est multifactorielle. Pour y trouver des solutions, il convient d’examiner la surcharge dans la globalité du système de soins à la française. Nous présentons donc une revue de la littérature afin de dégager les causes, les conséquences de la surcharge, mais aussi d’en ébaucher les solutions.

Abstract

Abstract The maturation of emergency medicine as a specialty has coincided with increases in emergency department (ED) visit rates, both in France and around the world. Overcrowding in EDs occurs when the physical or staffing capacity of the department is exceeded by the number of patients waiting to be seen, undergoing assessment and treatment or waiting for departure. ED overcrowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. Overcrowding occurs in France and elsewhere in the developed world and has been well documented over the past decade. It became generally recognised that this problem had come about through a combination of factors. To find solutions, we must examine ED crowding in the context of the entire French delivery system. We present a review to understand its causes, its consequences and develop potential solutions.

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Authors and Affiliations

  1. Pôle anesthésie-réanimation-douleur-urgences, CHU de Nîmes, place du Professeur-Robert-Debré, F-30029, Nîmes cedex 09, France

    P.-G. Claret, X. Bobbia & P. Richard

  2. Directeur de la clientèle, CHU de Nîmes, place du Professeur-Robert-Debré, F-30029, Nîmes cedex 09, France

    F. Poher

  3. Pôle anesthésie-réanimation-douleur-urgences, université Montpellier-Nîmes, CHU de Nîmes, place du Professeur-Robert-Debré, F-30029, Nîmes cedex 09, France

    J.-E. de La Coussaye

Authors
  1. P.-G. Claret
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  2. X. Bobbia
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  3. P. Richard
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  4. F. Poher
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  5. J.-E. de La Coussaye
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Correspondence to P.-G. Claret.

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Claret, PG., Bobbia, X., Richard, P. et al. Surcharge du service des urgences : causes, conséquences et ébauches de solutions. Ann. Fr. Med. Urgence 4, 96–105 (2014). https://doi.org/10.1007/s13341-014-0415-5

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  • DOI: https://doi.org/10.1007/s13341-014-0415-5

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