\u200b\u200bLa circulaire n\u00b0 DGOS\/FIP3\/P1\/P2\/DSS\/1A\/2026\/138 du 29 septembre 2026, sign\u00e9e par la ministre de la sant\u00e9, des familles, de l’autonomie et des personnes handicap\u00e9es, pr\u00e9cise les modalit\u00e9s d\u2019appui \u00e0 la mise en \u0153uvre de la d\u00e9marche de performance des \u00e9tablissements de sant\u00e9 sur le champ du \u00ab juste recours \u00bb \u00e0 l\u2019h\u00f4pital. Elle s\u2019inscrit dans le prolongement de l\u2019instruction du 9 octobre 2025 relative \u00e0 l\u2019efficience et \u00e0 la performance des \u00e9tablissements de sant\u00e9, en particulier pour les alternatives \u00e0 l\u2019hospitalisation.<\/p>\n
Adress\u00e9e aux directeurs g\u00e9n\u00e9raux des agences r\u00e9gionales de sant\u00e9 (ARS), la circulaire demande la r\u00e9alisation d\u2019un autodiagnostic du juste recours \u00e0 l\u2019h\u00f4pital, la mobilisation des leviers existants pour am\u00e9liorer ce recours et l\u2019utilisation des outils d\u2019accompagnement disponibles. L\u2019objectif est d\u2019orienter les prises en charge vers les modalit\u00e9s les plus adapt\u00e9es, en \u00e9vitant les hospitalisations non pertinentes.<\/p>\n
Les r\u00e9sultats attendus portent sur cinq axes principaux : acc\u00e9l\u00e9rer le d\u00e9veloppement de l\u2019hospitalisation \u00e0 domicile (HAD), augmenter la part des prises en charge alternatives \u00e0 l\u2019hospitalisation compl\u00e8te, promouvoir la pertinence des soins, redresser la situation financi\u00e8re des \u00e9tablissements de sant\u00e9 dans une logique pluriannuelle et consolider la contractualisation avec les \u00e9tablissements en difficult\u00e9 budg\u00e9taire. La circulaire demande une mise en \u0153uvre dans les meilleurs d\u00e9lais, sans calendrier d\u00e9taill\u00e9.<\/p>\n
Plusieurs directions de l\u2019administration centrale sont impliqu\u00e9es : la Direction g\u00e9n\u00e9rale de l\u2019offre de soins (DGOS), via la sous-direction du financement et de la performance du syst\u00e8me de sant\u00e9 et la sous-direction de la prise en charge hospitali\u00e8re et des parcours ville-h\u00f4pital, ainsi que la Direction de la s\u00e9curit\u00e9 sociale (DSS) via la sous-direction du financement du syst\u00e8me de soins et le bureau \u00c9tablissements de sant\u00e9 et \u00e9tablissements m\u00e9dico-sociaux (1A). Des contacts nominativement identifi\u00e9s sont fournis pour le suivi op\u00e9rationnel.<\/p>\n
La circulaire est accompagn\u00e9e de quatre annexes techniques visant \u00e0 outiller les ARS et les \u00e9tablissements : un autodiagnostic et un panel national d\u2019actions pour l\u2019HAD (annexe 1), une m\u00e9thodologie d\u2019enqu\u00eate de pertinence des s\u00e9jours sur un jour donn\u00e9 avec un panel d\u2019actions associ\u00e9es (annexe 2), une liste d\u2019indicateurs pour le macrodiagnostic \u00ab juste recours \u00e0 l\u2019h\u00f4pital \u00bb (annexe 3) et un recensement des outils d\u2019accompagnement \u00e0 la mise en \u0153uvre propos\u00e9s par l\u2019ANAP \u00e0 l\u2019automne 2026 (annexe 4). Ces outils visent \u00e0 structurer l\u2019analyse des pratiques de recours \u00e0 l\u2019h\u00f4pital et \u00e0 soutenir les d\u00e9marches d\u2019am\u00e9lioration.<\/p>\n
Les dispositions de la circulaire s\u2019appliquent aux Outre-mer, \u00e0 l\u2019exception de la Polyn\u00e9sie fran\u00e7aise, de la Nouvelle-Cal\u00e9donie et de Wallis-et-Futuna. Aucun \u00e9l\u00e9ment chiffr\u00e9 pr\u00e9cis n\u2019est communiqu\u00e9 dans le texte fourni, mais l\u2019accent est mis sur l\u2019am\u00e9lioration de la performance m\u00e9dico-\u00e9conomique et de la soutenabilit\u00e9 financi\u00e8re des \u00e9tablissements de sant\u00e9, en lien avec une meilleure pertinence des prises en charge.\u00a0 (contenu r\u00e9sum\u00e9 en fran\u00e7ais par l’IA) Lire la Suite<\/a><\/p>","protected":false},"excerpt":{"rendered":" \u200b\u200bLa circulaire n\u00b0 DGOS\/FIP3\/P1\/P2\/DSS\/1A\/2026\/138 du 29 septembre 2026, sign\u00e9e par la ministre de la sant\u00e9, des familles, de l’autonomie et des personnes handicap\u00e9es, pr\u00e9cise les modalit\u00e9s d\u2019appui \u00e0 la mise 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