Jordan Ellis
France's healthcare system is a mix of public and private hospitals. As of 2020, there were 2,989 hospitals in France, with 1,347 public hospitals, 972 private for-profit hospitals, and 670 private not-for-profit hospitals. The French healthcare system is renowned for its excellence in medical, organizational, and economic fields, with private establishments at the forefront of outpatient surgery and flexibility in incorporating innovations. The country's university hospitals are dedicated to care, teaching, and research, fostering a synergy between doctors and researchers that attracts talent from around the world. France's healthcare system has also demonstrated its adaptability and resilience, particularly during the COVID-19 pandemic, where hospital workers swiftly redirected research efforts, developed teleconsultation, and transformed organizations to increase intensive care capacity.
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What You'll Learn
- There were 2,987 hospitals in France in 2021
- The French system includes public and private hospitals
- Publicly-owned hospitals are run by government or public corporations
- Private hospitals are at the forefront of outpatient surgery and quick to innovate
- French hospitals have a threefold mission: care, teaching, and research. They also have emergency services
There were 2,987 hospitals in France in 2021
France's healthcare system is a mix of public and private acute hospitals. In 2021, there were 2,987 hospitals in France. This number has fluctuated over the years, with a steady decrease between 2000 and 2012, when the number of hospitals dropped from 3,120 to 2,657. However, during the first year of François Hollande's presidency, the number of hospitals increased significantly, with a particular focus on expanding publicly-owned hospitals.
The French healthcare system is known for its excellence in medical, organizational, and economic fields. Private establishments play a crucial role in outpatient surgery and are renowned for their flexibility in incorporating innovations. They also excel in managing establishments, creating new structures, and training hospital teams. France's university hospitals have a threefold mission: care, teaching, and research. This model fosters a synergy between doctors and researchers, attracting talent through renowned public research institutions.
The country's healthcare system has also made strides in scientific publications, particularly in oncology, with over 59,000 publications between 2010 and 2019. This has led to significant therapeutic innovations, such as reducing mortality in childhood acute lymphoblastic leukemia from over 50% to less than 5% over 40 years. The university hospital model has proven its worth, facilitating international knowledge sharing and optimal patient care.
The French hospital system is further supported by the upcoming implementation of the access to care service (SAS), which aims to provide patient-centred care and reduce emergency room congestion. This service builds upon the existing SAMU (emergency medical service), offering a joint telephone number for hospital emergency professionals and city doctors. The SAS is expected to be widely used, providing a new organizational model for healthcare.
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The French system includes public and private hospitals
The French healthcare system is a mix of public and private services. Hospitals can belong to one of several categories: public facilities, chartered private non-profit facilities, and private for-profit facilities. As of 2004, about 62% of French hospital capacity was met by publicly owned and managed hospitals. The remaining capacity was split evenly (18% each) between non-profit sector hospitals and for-profit institutions.
At the end of 2020, out of 2,989 establishments, there were 1,347 public hospitals, 972 private for-profit, and 670 private non-profit establishments. Public hospitals provide 66% of beds and places, while private for-profit and private non-profit provide 25% and 9% respectively.
The French government sets the national health strategy and allocates budgeted expenditures to regional health agencies, which are responsible for planning and service delivery. Enrollment in France's statutory health insurance system is mandatory, and the government covers much of the per capita health expenses. In 2022, around $6,517 USD was spent per person in healthcare, of which $5,510 USD was covered by the public health system.
Patients in France are free to choose their primary care physician, which can be filled by a general practitioner or specialist physician. The patient can change primary care physicians at any time. General practitioners are expected to act as gatekeepers who refer patients to a specialist or a hospital when necessary. There is a free choice of the reference doctor, which is not restricted to only general practitioners and may still be a specialist or a doctor in a public or private hospital.
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Publicly-owned hospitals are run by government or public corporations
France has a mix of public and private hospitals. Publicly-owned hospitals are run by government or public corporations, with the general corporate policies of these hospitals determined by public organisations, especially in terms of operating and funding. The French government sets the national health strategy and allocates budgeted expenditures to regional health agencies, which are responsible for planning and service delivery. The Ministry of Social Affairs, Health, and Women's Rights is responsible for defining the national health strategy, including the organisation and financing of the healthcare system. The central government allocates budgeted expenditures among different sectors, including hospitals, and regions. The Ministry of Social Affairs, Health, and Women's Rights is represented in the regions by Regional Health Agencies, which are responsible for coordinating population health and healthcare, including prevention and care delivery, public health, and social care.
Public hospitals are funded mainly by Statutory Health Insurance (80%), with voluntary insurance and direct patient payments accounting for the remaining income. Public hospitals also receive research and teaching grants (up to 13% of hospital budgets). In 2020, there were 1,347 public hospitals in France, providing 66% of hospital beds. This figure remained roughly the same in 2021, with 1,344 public hospitals. As of 2004, about 62% of French hospital capacity was met by publicly-owned hospitals, with the remaining capacity split evenly (18% each) between non-profit sector hospitals and for-profit institutions. Non-profit sector hospitals tend to be owned by foundations, religious organisations, or mutual insurance associations.
The French government generally refunds patients 70% of healthcare costs, and 100% in the case of costly or long-term ailments. Supplemental coverage may be purchased from private insurers. Publicly-owned hospitals in France saw an abrupt increase during the first year of former French President François Hollande's presidency, rising from 928 hospitals in 2012 to 1,458 hospitals in 2013.
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Private hospitals are at the forefront of outpatient surgery and quick to innovate
The French hospital system comprises both public and private acute hospitals. In 2020, there were 2,989 hospitals in France, including 1,347 public hospitals, 972 private for-profit institutions, and 670 private not-for-profit establishments. Notably, the private sector has been at the forefront of outpatient surgery, offering several advantages to patients.
Outpatient surgery centers, also known as ASCs, provide surgical care without requiring patients to stay overnight. This model offers significant benefits, including reduced costs, improved accessibility, and enhanced patient comfort. The structure of outpatient surgery centers enables increased productivity, resulting in substantial cost savings for patients, insurers, and taxpayers. For example, the Department of Health and Human Services estimated savings of $15 billion for taxpayers and $3 billion for Medicare patients if all qualifying surgeries were performed at outpatient surgery centers.
Outpatient surgery centers also offer improved safety and cleanliness. The Centers for Disease Control and Prevention reported that in 2010, approximately 8.95 per 1,000 patients developed a surgical site infection (SSI) in a hospital setting, compared to only 4.84 per 1,000 patients in an ASC. This improved safety is due to the thorough screening of patients' medical histories before surgery, ensuring that individuals with contagious diseases do not undergo procedures at outpatient surgery centers.
Additionally, outpatient surgery centers provide better control over scheduling, resulting in fewer delays or rescheduling of procedures. This advantage is particularly relevant compared to hospitals, where unexpected factors, such as emergency room demands, can cause disruptions. The improved scheduling efficiency contributes to a less stressful experience for patients, especially children, who often prefer to recover at home rather than in a hospital environment.
Private hospitals, including outpatient surgery centers, play a pivotal role in driving innovation and enhancing the patient experience. They continuously invest in cutting-edge medical equipment and advanced technologies to improve diagnostic accuracy, treatment effectiveness, and overall patient satisfaction. By embracing innovation and strategic partnerships, private hospitals contribute to the development of healthier communities and economic growth. Their commitment to staying at the forefront of medical technology ensures they deliver superior healthcare services.
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French hospitals have a threefold mission: care, teaching, and research. They also have emergency services
French hospitals are highly regarded internationally, and for good reason. They are responsible for organising complex care, promoting research, disseminating therapeutic innovations, training healthcare professionals, and guaranteeing access to care for all. Indeed, French hospitals have a threefold mission: care, teaching, and research.
The French hospital system is made up of public and private acute hospitals. In 2021, there were 2,987 hospitals in France, with 1,347 public hospitals, 972 private for-profit hospitals, and 670 private not-for-profit hospitals. The number of hospitals in France decreased between 2000 and 2012, but this trend was abruptly reversed during the first year of the Hollande Presidency, with a notable increase in publicly-owned hospitals.
French hospitals are integral to the nation's identity. They are responsible for some of the most complex care, including the management of an ageing population, an increase in chronic diseases, and the acceleration of the digital revolution. The Covid-19 pandemic further highlighted the resilience of French hospitals, with hospital workers swiftly adapting to the situation, redirecting research efforts, and developing teleconsultation.
French hospitals are also responsible for teaching and training. They are major players in the training of healthcare professionals, with teaching hospitals called CHU (Centre hospitalier universitaire). These are regional hospitals with agreements with one or more universities. As part of their agreements, medical staff act as both practitioners and teachers, receiving dual compensation. There is at least one CHU per French administrative region.
Lastly, French hospitals are committed to research. They promote and disseminate therapeutic innovations and conduct scientific and medical research. For example, the Bordeaux University Hospital acquired two new surgical robots for use in urology, gynaecology, cardiac and thoracic surgery, enabling more precise and less invasive surgery. Additionally, the forthcoming roll-out of the access to care service (SAS) will provide patients with dedicated care and relieve congestion in emergency rooms.
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Frequently asked questions
As of 2020, there were 2,989 hospitals in France.
As of 2020, there were 1,347 publicly owned hospitals in France. This number decreased slightly to 1,344 in 2021.
As of 2020, there were 1,642 private hospitals in France, 972 of which were for-profit, and 670 were not-for-profit.
Yes, the number of hospitals in France has fluctuated. Between 2000 and 2012, the number of hospitals decreased from 3,120 to 2,657. However, in 2013, the number of hospitals increased to 3,192.
