Paediatric anaesthesia in France: National data on outpatient procedures, emergency admissions, and critical outcomes in 2023.

Background: Outpatient paediatric anaesthesia has been promoted as a national objective in France, with a target rate of 80%. However, outpatient care rates vary widely across institutions, reflecting differences not only in organizational models but also in patient demographics, clinical complexity, and admission pathways. Understanding these variations requires a comprehensive analysis that includes both ambulatory and non-ambulatory cases to identify structural and clinical factors that limit outpatient feasibility.

Methods: The number of anaesthesia cases in 2023 was obtained from the French national PMSI database of short-stay healthcare institutions. For each recorded anaesthesia procedure, the collected information included the type of healthcare institution (public or private hospital), length of stay (0 day or more), type of procedure involving anaesthesia, admission status (emergency: yes/no), whether there was a related intensive care unit stay, child mortality, and the child's age and gender.

Results: In 2023, 990,296 anaesthesia procedures were performed over 704,796 individual stays for children aged 0 to 17. Overall, outpatient stays accounted for 76.2%. Over 90% of paediatric anaesthesia stays in private hospitals were outpatient, whereas 58.8% of stays involving anaesthesia for children occurred in public hospitals. The number of stays for children under one year was 20,373 in public hospitals and 1,280 in private hospitals, which included 4,657 (22.8%) and 931(72.7%) outpatients, respectively.

Conclusions: Prioritising personalised healthcare pathways, strengthening local and regional healthcare organisations according to patient characteristics and needs, are more suitable than simply increasing outpatient rates.