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Public and private acute hospitals, between competition and cooperation


The French hospital system is made up of public and private acute hospitals. At the end of 2020, out of 2,989 establishments, there were 1,347 public hospitals, 972 private for-profit and 670 private not-for-profit establishments, the majority of which were public-interest private healthcare establishments (ESPIC). This report focuses on medicine, surgery and obstetrics (MCO). In this field of activity, public hospitals provide 66 % of beds and places, private for profit 25 % and private not-for-profit 9 %. Based on the work of the Court of Accounts and the regional audit chambers, this report analyses the characteristics of public and private hospital provision, both for-profit and not-for profit, the factors likely to improve or penalize the efficiency of its organisation and overall performance, and the means used by the regulatory authorities, at national and regional level, to best meet the population’s hospital acute care needs.

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