“In 24 hours, 45% of people who come to the hospital are not in an emergency situation”: the reminder from the Cannes hospital center

The emergency reception service at the Simone-Veil hospital center in Cannes sees around 50,000 visits each year, or an average of 133 patients per day. It is open all year round, 7 days a week, 24 hours a day. Given the attractiveness of the city and the numerous events, the Cannes hospital center is the establishment which experiences the largest peak of activity in the department over the period from May to October. The teams are therefore preparing to enter the most tense period of the year. Questions for Estelle Winter, head of the department.

According to a national survey, in one day, 45% of patients presenting to the emergency room did not need it. Can you explain to us?

This trend is found in the majority of French hospitals. In a recently conducted national poll. The French Hospital Federation also showed that 54% of people surveyed in 2024 say they have gone to the emergency room for reasons not related to a medical emergency.

We still have people for a sports medical certificate, a renewal of a prescription, a vaccination, an extension of sick leave, for radiology without a medical prescription, etc.

There are also false ideas among some people…

Coming to the emergency room in the middle of the night for a non-urgent case, assuming that there will be fewer people and that you will be able to see a doctor quickly, coming to the emergency room thinking that the treatment is free… These are erroneous reasonings which harm patients and healthcare professionals.

What impact does the influx of non-urgent cases have on the ability of emergency services to treat truly critical cases?

The influx of non-urgent cases does not, strictly speaking, impact the most critical cases which are subject to specific treatment. On the other hand, it creates a congestion of emergencies while professionals are intended to prioritize vital emergencies, which require an immediate response in terms of medical care and resources. Emergency professionals save lives every day, relieve severe pain, treat serious injuries and perform expert procedures. For this, they have the support of medical-technical services (laboratory, imaging, operating theaters) and resuscitation. Emergency services are open to everyone, serving everyone. But, to remain effective, they must focus on patients in a real state of emergency. Emergency departments should not be the alpha and omega of the health system.

How does the management of these cases influence the wait time for all patients?

It is first important to understand that the time it takes to go to the emergency room depends not only on the patient’s arrival time.

What does it depend on, then?

Several factors: the number of patients present in the emergency room, the level of severity determined by the reception and orientation nurse and by the emergency doctor. And then, the type of emergency: medical, surgical or traumatological, necessary examinations: imaging, blood tests, opinions sought from specialist doctors (surgeon, cardiologists, etc.). Finally, the arrival of patients in life-threatening emergencies.

As a result, the arrival of non-urgent cases leads to an increase in the average length of time spent in the emergency room.

It was 4:52 in 2023 at the Cannes hospital center. This can put the entire hospital under strain. By using emergency services appropriately, healthcare professionals can save treatment time. Appropriate recourse to emergencies can also help limit people’s dissatisfaction with these waiting times.

How do you think educating the public on the proper use of emergency services could improve the situation?

It is essential, as is the general health education of citizens. In our field, four actions can be highlighted: the poster worked between the city and the hospital with the extra-municipal health commission and the territorial professional health community Pays de Lérins; the partnerships with non-scheduled care structures that the hospital has established allow reorientation towards other structures (medical center on call, care practice with extended hours, general practitioner available, etc.). Partnerships with EHPADs and community medicine to encourage unscheduled direct admissions to hospital departments without going to the emergency room (CH Connect smartphone application). The interactive map set up by the Regional Health Agency at points of care is an important tool.

How can technology play a role in reducing unnecessary emergency room visits?

The objective of the access to care service (SAS) carried out at the departmental level by the Regional Health Agency and the Nice University Hospital Center is to ensure the care of a patient faced with a need for urgent care and unscheduled care, and direct them if necessary to a practitioner in town for an appointment. The SAS, accessible by telephone via 15, aims to offer the population more understandable and coordinated care between community medicine and health establishments in order, in particular, to limit recourse to avoidable emergencies and improve the access to unscheduled care in town.