Elderly people in care

homes (EHPAD)

Executive summary

2022 Annual Public Report

2

The health crisis has particularly hit the 7,500 care homes for dependent elderly people

(EHPAD) and their 600,000 residents. 80% of care homes were hit between March 2020 and

March 2021. During this period, the pandemic caused nearly 34,000 deaths, which represents

36% of all deaths recorded in France due to Covid. This particular vulnerability cannot be

explained solely by the fragility of the residents. It also derives from the structural difficulties of

care homes, which call for radical reform, beyond the very significant credits that have been

released both for managing the crisis itself and wi

thin the framework of the ‘Ségur de la santé’

plan.

A high cost in human terms until vaccinations were rolled out, revealing

the structural deficiencies of nursing homes and the vulnerability of their

residents

The first two waves in March to July then August to December 2020 resulted in an

equivalent number of deaths in care homes (just over 14,500 for each period). Their

characteristics and the context in which they occurred were however, very different.

The first wave was concentrated in two regions (Île-de-France and Grand Est), lasted a

few weeks and was characterised by a shortage of personal protective equipment, lack of

testing and particularly drastic protocols. The second wave was broader in geographic terms,

and lasted longer. The measures taken took greater account of territorial realities and above

all, better respected residents' freedom of movement and access by families.

The most affected regions (wave 1 and wave 2)

Source: Drees

In the first quarter of 2021, care homes largely escaped the third wave due to the success

of vaccinations. They nevertheless suffered 4,700 additional deaths linked to Covid-19 during

this period. This very high mortality can be explained by the profile of residents, but also by

well-known structural weaknesses despite the progress made since the beginning of the

2000s: insufficient medical care, severe pressure on human resources, poor integration into

healthcare networks and, sometimes, difficulties linked to the unsuitability of premises.

Short-

term and long-term support measures of an unprecedented amount, which must be

accompanied by structural reforms

. The cost, in terms of health insurance, of short-term

measures aimed in particular at offsetting additional expenses and loss of revenue of care

homes, reached €1.7 billion in 2020. In July 2020, long

-term funding measures were also taken

within the framework of the "Ségur de la santé” plan. It was then decided to make significant