{"id":4425,"date":"2014-06-11T10:26:20","date_gmt":"2014-06-11T08:26:20","guid":{"rendered":"http:\/\/chu-poitiers.ovh\/?p=4425"},"modified":"2015-04-17T12:07:52","modified_gmt":"2015-04-17T10:07:52","slug":"chu-de-poitiers-le-recours-en-plus","status":"publish","type":"post","link":"https:\/\/www.chu-poitiers.fr\/en\/chu-de-poitiers-le-recours-en-plus\/","title":{"rendered":"CHU de Poitiers : le recours en plus"},"content":{"rendered":"<p>Parce qu&#8217;il a un r\u00f4le leader au niveau r\u00e9gional en termes de soins, de recherche et de formation, un CHU doit proposer \u00e0 la collectivit\u00e9 m\u00e9dicale et \u00e0 la population une offre de soins compl\u00e9mentaires \u00e0 celles des autres centres hospitaliers de son territoire. Notamment en apportant des techniques m\u00e9dicales innovantes et des comp\u00e9tences particuli\u00e8res, c&#8217;est ce qu&#8217;on appelle le recours. Pour Bertrand Debaene, pr\u00e9sident de la commission m\u00e9dicale d&#8217;\u00e9tablissement (CME) du CHU de Poitiers, le recours, \u00ab\u00a0ce sont toutes les activit\u00e9s que les autres centres hospitaliers ne dispensent pas parce qu&#8217;ils n&#8217;ont pas les savoir-faire m\u00e9dicaux, les plateaux techniques ou encore les laboratoires sp\u00e9cialis\u00e9s\u00a0\u00bb.<\/p>\n<h3>N\u00e9cessit\u00e9 \u00e9conomique<\/h3>\n<p>Il n&#8217;y a pas de d\u00e9finition \u00e0 proprement parler du recours mais le CHU de Poitiers travaille actuellement sur une qualification de ses activit\u00e9s de r\u00e9f\u00e9rence et de recours en s&#8217;appuyant sur certains crit\u00e8res comme le niveau d&#8217;expertise, la s\u00e9v\u00e9rit\u00e9 des patients, le passage en r\u00e9animation (voir encadr\u00e9 ci-dessous).<\/p>\n<table bgcolor=\"ffffff\">\n<tbody>\n<tr>\n<td><strong>Qualification des activit\u00e9s de recours<\/strong>Dans le champ de la m\u00e9decine chirurgie obst\u00e9trique, le CHU de Poitiers oeuvre actuellement sur la qualification de ses activit\u00e9s de r\u00e9f\u00e9rence et de recours r\u00e9alis\u00e9es pour les patients de Poitou-Charentes et hors r\u00e9gion. Pour cela, il utilise un outil \u00e9labor\u00e9 en 2002 par un groupe de travail des d\u00e9partements d&#8217;information m\u00e9dicale des CHU de Rh\u00f4ne-Alpes et valid\u00e9 statistiquement. Cet outil permet de quantifier l&#8217;attractivit\u00e9 et les taux de fuite d&#8217;activit\u00e9s selon plusieurs crit\u00e8res : le niveau de sp\u00e9cialisation (prise en charge d&#8217;au moins 80% des patients sur une activit\u00e9 donn\u00e9e), la s\u00e9v\u00e9rit\u00e9 des patients pris en charge (s\u00e9jours avec au moins une complication et une morbidit\u00e9 associ\u00e9e s\u00e9v\u00e8re), le passage en r\u00e9animation, la part journali\u00e8re des d\u00e9penses m\u00e9dicales et pharmaceutiques hospitali\u00e8res.<\/p>\n<p>Pour mesurer un niveau de recours, sont pris en compte les patients domicili\u00e9s au-del\u00e0 du bassin d&#8217;attractivit\u00e9 de l&#8217;\u00e9tablissement compte tenu de sa notori\u00e9t\u00e9.<\/p>\n<p>Ainsi, sur l&#8217;ann\u00e9e 2012, la liste des activit\u00e9s repr\u00e9sentant un fort niveau de r\u00e9f\u00e9rence et de recours est la suivante\u00a0: la chirurgie cardio-thoracique, la chirurgie majeure sur le thorax, la chirurgie du rachis, la pose de neurostimulateurs, la greffe de moelle, les maladies immunitaires du sang, la prise en charge des nouveau-n\u00e9s pr\u00e9matur\u00e9s, la transplantation r\u00e9nale. L&#8217;ensemble des s\u00e9jours pour ces activit\u00e9s de recours, soit 2\u00a0233, repr\u00e9sentent un co\u00fbt total de 31\u00a0396\u00a0889\u00a0euros pour l&#8217;\u00e9tablissement.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Si le recours s&#8217;inscrit dans une dimension de soins compl\u00e9mentaires offerts \u00e0 la collectivit\u00e9, il r\u00e9pond aussi \u00e0 une n\u00e9cessit\u00e9 \u00e9conomique. \u00ab\u00a0Une activit\u00e9 de haute technicit\u00e9 n&#8217;a de sens en termes d&#8217;investissements et au regard du nombre de patients \u00e0 l&#8217;\u00e9chelle d&#8217;un bassin de sant\u00e9 que si elle est regroup\u00e9e dans un endroit bien cibl\u00e9. Et cette centralisation offre d&#8217;ailleurs une bien meilleure prise en charge. Car, on ne fait bien que ce qu&#8217;on fait beaucoup.\u00a0\u00bb<\/p>\n<p>Toute la complexit\u00e9 pour un CHU est de jongler avec la dualit\u00e9 qui est de proposer une offre de soins de proximit\u00e9 coh\u00e9rente et vaste et en m\u00eame temps privil\u00e9gier une m\u00e9decine de recours hyper sp\u00e9cialis\u00e9e. \u00ab\u00a0C&#8217;est compliqu\u00e9. \u00c0 quel niveau faut-il placer le curseur\u00a0? Faire plus de proximit\u00e9 que de recours\u00a0? s&#8217;interroge le professeur Debaene. La volont\u00e9 institutionnelle est clairement de se positionner sur l&#8217;offre de recours car il en va de \u001cnotre survie\u001d. Si nous ne pouvons pas proposer mieux qu&#8217;un centre hospitalier de proximit\u00e9, nous n&#8217;avons plus notre raison d&#8217;\u00eatre.\u00a0\u00bb Aussi, le CHU de Poitiers m\u00e8ne-t-il depuis plusieurs ann\u00e9es une politique de recrutement de m\u00e9decins et de chirurgiens hautement qualifi\u00e9s. Il enrichit constamment son plateau technique qui assoit aujourd&#8217;hui son statut d&#8217;\u00e9tablissement de r\u00e9f\u00e9rence r\u00e9gional.<\/p>\n<p><a href=\"https:\/\/www.chu-poitiers.fr\/eBooks\/ChuMag68\/index.html#\/16\/\" target=\"_blank\">Lire la suite dans le CHU magazine de juin.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Parce qu&#8217;il a un r\u00f4le leader au niveau r\u00e9gional en termes de soins, de recherche et de formation, un CHU doit proposer \u00e0 la collectivit\u00e9 m\u00e9dicale\u2026","protected":false},"author":1,"featured_media":4430,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4425","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>CHU de Poitiers : le recours en plus - Site du CHU de Poitiers<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chu-poitiers.fr\/en\/chu-de-poitiers-le-recours-en-plus\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CHU de Poitiers : le recours en plus - Site du CHU de Poitiers\" \/>\n<meta property=\"og:description\" content=\"Parce qu&#8217;il a un r\u00f4le leader au niveau r\u00e9gional en termes de soins, de recherche et de formation, un CHU doit proposer \u00e0 la collectivit\u00e9 m\u00e9dicale et \u00e0 la population une offre de soins compl\u00e9mentaires \u00e0 celles des autres centres hospitaliers de son territoire. 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