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112 Health systems in transition France Nurses Nurses and nursing aides form the two largest groups of health professionals in France. In 2013, there were 595 594 nurses in France. With 1000 nurses per 100 000 inhabitants in 2013, the density of nurses in France is relatively low compared with neighbouring European countries such as Germany, but higher than the EU28 average (Fig. 4.4). However, this fact is difficult to interpret given the differences in the scope of tasks performed by nurses and nursing aides in different countries. The number of nurses steadily increased between 1991 and 2013 at an average growth rate of 3.0% per year (Eco-Santé, 2014), following a progressive increase in the numerus clausus since 1993. However, this increase in the workforce has not been sufficient to meet the rapidly increasing demand. Moreover, there are large persisting geographical disparities in the density of self-employed nurses, which parallel those observed for physicians (Sicart, 2013b). Incentives to control the geographical distribution of nurses’ settlement of a new practice have been set up under the 2007 agreement. Limits have been established in areas with high density, and financial and material incentives are offered to encourage new practices in underserved areas. Nurses may specialize in various fields, including paediatrics, anaesthesia and surgery. Between 2009 and 2011, an average of 513 000 nursing aides were employed in health care institutions, providing routine nursing care such as maintaining personal hygiene and assistance with essential bodily functions. Their involvement remains marginal in outpatient settings, where they mainly work in SSIAD (see section 5.8.1) under the auspices of specific services that employ them. Midwives Midwifery is a distinct medical profession, with field of practice restricted to non-pathological situations. There were 20 035 midwives practising in France in 2013. While recent years have seen an increase in the share of self-employed midwives, geographic disparities are less of an issue than among physicians and nurses, because the majority of midwives are hospital based. Midwives in the ambulatory sector play a key role in facilitating shorter stays in maternity hospitals.
Health systems in transition France 113 Dentists and dental auxiliaries There were 40 833 dentists in France in 2013. The number of dentists has been relatively stable over recent years compared with other medical professions: between 1991 and 2013, the number of dentists in France rose by 7.0%, corresponding to an annual increase of 0.3% (Eco-Santé, 2014). The resulting density of dentists is high compared with other European countries (Fig. 4.5); nevertheless, this profession is subject to the same geographical disparities as other health care professions. Fig. 4.5 Number of dentists per 100000 population in France and selected countries, 1990–2013 90 Dentists/100,000 population 80 Germany 70 60 EU Spain Italy France 50 United Kingdom 40 30 20 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Source: WHO Regional Office for Europe, 2015. Note: Data for France not available for 1990–2010. Some procedures carried out by dentists – notably orthodontic processes and the fitting of prostheses – are also performed by stomatologists (specialist doctors). The area of expertise of the stomatologist is more extensive, however, also covering surgery of the mouth and teeth. In 2011, 85% of the 1246 stomatologists in France were self-employed. There is no recognized profession of dental hygienist in France; dental assistants perform administrative activities in the practices of dentists and stomatologists.
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Contents Contents Preface
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Preface Preface The Health Systems
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Acknowledgements Acknowledgements T
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Abstract Abstract This analysis of
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1. Introduction 1. Introduction The
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3. Financing 3. Financing Health ca
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France

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