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Article Dans Une Revue Annals of Intensive Care Année : 2024

Inadequate intensive care physician supply in France: a point-prevalence prospective study

1 GRHVN - Groupe de Recherche sur le Handicap Ventilatoire et Neurologique
2 CHU Rouen
3 CIC - Centre d’Investigation Clinique [Tours] CIC 1415
4 F-CRIN research network - Réseau CRICS-TRIGGERSEP [CHRU Tours]
5 CEPR - Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100
6 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie
7 Hôpital Lariboisière-Fernand-Widal [APHP]
8 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
9 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
10 ASIH - Adaptateurs de signalisation en hématologie
11 Hôpital Cochin [AP-HP]
12 Centre Hospitalier Le Mans (CH Le Mans)
13 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
14 Hôpital Privé Jacques Cartier [Massy]
15 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
16 TBIP - Biome Tropical et Immuno-Pathophysiologie = Tropical Biome and ImmunoPhysiopathology [Lille]
17 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
18 CIIL - Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204
19 CH E.Muller Mulhouse - Centre Hospitalier Emile Muller [Mulhouse]
20 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
21 CHU Pitié-Salpêtrière [AP-HP]
22 GRC 30 - RESPIRE - Groupe de recherche cinique Réanimation et soins intensifs du patient en Insuffisance respiratoire aigüe
23 IHU ICAN - Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière]
24 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
25 UR - Université de Rennes
26 ETHICS EA 7446 - Experience ; Technology & Human Interactions ; Care & Society :
27 GHICL - Groupement des Hôpitaux de l'Institut Catholique de Lille
28 CH Béthune - Centre Hospitalier de Béthune
29 ISCHEMIA - Membrane Signalling and Inflammation in reperfusion Injuries
30 CHRO - Centre Hospitalier Régional d'Orléans
31 UA - Université d'Angers

Résumé

Background: The COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation. A national e-survey was conducted among French ICUs in January 2022 to collect data on ICU characteristics, medical staffing, individual physician characteristics, and education and training capacities.Results Among 290 ICUs contacted, 242 responded (response rate: 83%), representing 4943 ICU beds. The survey revealed an overall of 300 full time equivalent (FTE) ICU physician vacancies in the country. Nearly two-thirds of the participating ICUs reported at least one physician vacancy and 35% relied on traveling physicians to cover shifts. The ICUs most affected by physician vacancies were the ICUs of non-university affiliated public hospitals. The retirements expected in the next five years represented around 10% of the workforce. The median number of physicians per ICU was 7.0, corresponding to a ratio of 0.36 physician (FTE) per ICU bed. In addition, 27% of ICUs were at risk of critical dysfunction or closure due to vacancies and impending retirements.Conclusion: The findings highlight the urgent need to address the shortage of ICU physicians in France. Compared to a similar study conducted in 2012, the inadequacy between ICU physician supply and demand has increased, resulting in a higher number of vacancies. Our study suggests that, among others, increasing the number of ICM residents trained each year could be a crucial step in addressing this issue. Failure to take appropriate measures may lead to further closures of ICUs and increased risks to patients in this healthcare system.
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Dates et versions

hal-04623186 , version 1 (25-06-2024)

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Sacha Sarfati, Stephan Ehrmann, Dominique Vodovar, Boris Jung, Nadia Aissaoui, et al.. Inadequate intensive care physician supply in France: a point-prevalence prospective study. Annals of Intensive Care, 2024, 14 (1), pp.92. ⟨10.1186/s13613-024-01298-y⟩. ⟨hal-04623186⟩
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