title: [The obstetrics and gynaecology departments in the French public hospitals: an updated overview].
abstract: Restructuring the surgery and gynecology-obstetrics departments taking place now raise many interrogations. It appears as a mandatory necessity to some people and as a tribute to financial strategies to others to the detriment of quality and accessibility of care. Its effect is to clarify a good amount of socioeconomical and medical indicators. The plans of perinatality for the obstetrical aspect and the thresholds of activity for the surgical aspect constitute the major lines of these restructurings. A survey soliciting all the French public hospitals was used to assess the state of obstetrics and gynecology departments in the light of these recent restructurings. Medical demography, preserving and improving the quality and continuity of care, efficiency of the technical supports are discriminating criteria of the involved challenges. Such restructurings have an impact on the doctor's lives, which looks globally positive and a good omen to complete this remodeling process. The activity was safeguarded by a redistribution and a refocusing of institutions. One should not minimize the social impact of these changes, with a potential deterioration of working conditions (internal professional reclassifications, mobility obligation towards other sites). It thus appears that the deep changes which affect the small size institutions will be able to achieve well only if they are clearly done (information) and truly integrated in their medical project.
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, Thiers, France. enohuz@yahoo.fr
authors.forename: E
authors.initials: E
authors.lastname: Nohuz
authors.forename: J-C
authors.initials: JC
authors.lastname: Schumacher
authors.forename: M
authors.initials: M
authors.lastname: Alaboud
authors.forename: S
authors.initials: S
authors.lastname: Dalkiliç
authors.forename: Y
authors.initials: Y
authors.lastname: Lenglet
authors.forename: J
authors.initials: J
authors.lastname: Varga
authors.forename: M
authors.initials: M
authors.lastname: Ab Der Halden
authors.forename: D
authors.initials: D
authors.lastname: Chaumette
authors.forename: A
authors.initials: A
authors.lastname: Desroches
authors.forename: J
authors.initials: J
authors.lastname: Collet
authors.forename: A
authors.initials: A
authors.lastname: Brunel
authors.forename: G
authors.initials: G
authors.lastname: Dauptain
authors.forename: C
authors.initials: C
authors.lastname: Dognin
authors.forename: V
authors.initials: V
authors.lastname: Zerr
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000639:trends; D006176:Gynecology; D019538:Health Care Surveys; D006779:Hospitals, Public / Q000191:economics / Q000639:trends*; D006801:Humans; D009774:Obstetrics; D009775:Obstetrics and Gynecology Department, Hospital / Q000639:trends*; D010564:Personnel, Hospital; D010820:Physicians; D011247:Pregnancy; D011787:Quality of Health Care