Health. Emergency room wait times: 5.5 hours on average. In which departments is it the worst?

The Ministry of Health released new data this week on emergency room wait times. On average, the wait time from check-in to "discharge" is 5.5 hours—which translates to going home in 80% of cases, and hospitalization in the rest.

If we look at the median, half of the patients waited less than 3 hours and 6 minutes, the other half more. But the differences are particularly significant depending on the department.

A 24-hour “snapshot”

"The 2023 Emergency Department survey was conducted on Tuesday, June 13, 2023," for 24 hours, "from 8 a.m. in the morning until 8 a.m. the following day. The date was chosen outside of school vacation periods and seasonal epidemics, on a day of average weekday activity ," specifies the Drees, the statistical agency of the Ministry of Health. A sort of snapshot of a "typical" day, these data "are therefore not representative of the overall annual or weekly activity of emergency departments," specifies the Drees. They therefore cannot take into account a specific and/or localized event. The busiest day in emergency departments is Monday - this bias was therefore also avoided.

On the other hand, it allows, over a "standard" day, to identify potential geographical differences. To do this, no fewer than 719 emergency departments were studied, which saw a total of 56,475 patients in 24 hours.

Regionally, the longest waits are in the west of the country: the median wait time is 3 hours 48 minutes in the Pays de la Loire region, where a quarter of patients waited more than 6 hours 48 minutes. Wait times are still 3 hours 30 minutes in Brittany and Nouvelle-Aquitaine. In Normandy, half of patients wait 2 hours 36 minutes, and 2 hours 48 minutes in Bourgogne-Franche-Comté.

From single to triple between neighbors

But the differences lie in the details: in the Pays de la Loire region, for example, the median wait time is no more than 3 hours and 12 minutes in Maine-et-Loire, while it reaches 5 hours and 6 minutes in neighboring Vendée. The same goes for average wait times, with 5 hours and... 8 hours and 48 minutes respectively.

The same is true in the east of the country, with figures that vary almost double between the Vosges (2h24 median, 4h36 average) and neighboring Haute-Saône (4h24 and 7h). At the national level, only the Orne department, in Normandy, has a median wait of less than 2 hours. But the average wait exceeds 5 hours, with a quarter of patients waiting more than 4h42...

Many factors explain such differences: first, the availability of care, with sometimes three or fewer emergency services for an entire department, and sometimes many more. In the most urbanized and better-equipped departments, an alternative to emergency services "improves" hospital numbers (SOS doctors, health centers, etc.).

Closures and regulations appear to be lengthening the wait

Nighttime closures or the regulation put in place for access to certain emergency services also play a role, as Hamid Khaoua of Drees explains: " The closure of at least one emergency reception point affected 35 departments [...] In Ardèche, Alpes-de-Haute-Provence and Vendée, these structures accounted for more than 40% of visits" to emergency services. And regulated access concerned in certain departments (Tarn-et-Garonne, Dordogne, Haute-Loire and Lot-et-Garonne) "all emergency structures".

Medical demographics also play a role. At the same time, and since the same study conducted ten years earlier, the Samu (Emergency Medical Services) is referring patients to the emergency room much more often: "When asked 'who advised you to come to the emergency room?', 16% reported coming on the advice of the Samu-SAS, compared to 7% in 2013," according to the Drees (French Department for Emergency Medical Services). Here again, there are significant regional disparities: it's only 8% in Île-de-France and 12% in Paca, compared to around 25% in Brittany, Nouvelle-Aquitaine, and Pays de la Loire—the three regions with the longest waiting times.