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MARKET SUMMARY

1.1 Presentation and market definition

There are different types of clinics: specialized surgical clinics, follow-up and rehabilitation centres, and psychiatric clinics. The latter are grouped within the UNCPSY (Cliniques Psychiatriques de France).

The market for psychiatric clinics covers all of the independent psychiatric care units formerly known as nursing homes, with an average of 60 to 80 beds, outside the public hospital psychiatric sector. Clinics represent a significant alternative to hospitalizations in public facilities.

The European market reports very uneven situations between different countries in terms of number of beds per inhabitant, but also in the patient's approaches and methods of management.

In France, there is a concentration of private actors, a gradual decrease in the number of beds (despite sustained demand), and a progressive reduction of public allocations.

However, according to our estimates, the market is growing and weighs several billion euros. Psychiatric clinics tend to expand their services to younger patients and offers of part-time hospitalizations are in growth.

 

1.2 Very uneven reception capacities in Europe

Observation of the number of psychiatric hospital beds in European countries reveals a higher number of beds for two countries: France and Germany. However, these data need to be qualified. On the one hand, because patient care depends strongly on the type of social security system in a country, but also ...

1.3 The French market: decrease in available supply and market estimate

There are no precise data on the turnover of the private psychiatric clinics' sector in France. But it can, however, be approximated using the volume of activity (***) as well as the average cost. It is thus possible to estimate its evolution over the period ****-****.
First, the chart below highlights the ...

DEMAND ANALYSIS

2.1 The profile of psychiatric inpatients

Source: ****
Observation of the characteristics of patients followed in psychiatric institutions in **** reveals several structural differences:
In infant-juvenile psychiatry: The proportion of men is higher: representing **% of the total number of inpatient patients and **% of outpatient patients in this category. The share of partial hospitalization days is higher than the number ...

2.2 The type of treatment depends on each individual

Source: ****
There are significant differences in the pathology type according to gender (***)
For men hospitalization, the three most frequent pathologies are:
schizophrenia (***), mood disorders (***), mental and behavioural disorders related to the use of psychoactive substances (***).
For women, we find:
mood disorders (***), schizophrenia (***), neurotic disorders (***).

MARKET STRUCTURE

3.1 Three types of players coexist in a market where full-time hospitalisation clearly dominates

Distribution of the number of beds or places by type of player

By order: Public institutions, Private non-profit institutions, Private for-profit institutions
Source: ****
With nearly two-thirds of the market in terms of capacity, public institutions remain the number one player (***).
Private for-profit institutions represent only **% of reception capacity while private non-profit ...

3.2 A market concentration for private psychiatric clinics

A dynamic of concentration
A trend towards concentration can be observed in the private psychiatric clinics market. The acquisition by Inicea of Korian's psychiatric activity in ****, as well as the purchase carried out by Ramsay Santé of the Générale de Santé's ** Médipsy psychiatric clinics in the same ...

3.3 Uneven distribution of density and hospital places

The density of beds and hospital places in psychiatry

Source: ****
Observation of the density of psychiatric beds and hospital places in metropolitan France reveals significant regional disparities.
The rate per ***,*** inhabitants may vary from **.* (***).
The rate of coverage seems higher in Central France, while the West (***) is less well served.

Departmental ...

ANALYSIS OF THE OFFER

4.1 Costs in 2017 and structural trends

The unit of measurement used to apprehend the cost of the care provided is the reference frame of costs of labour units (***), which is calculated from national data from public and private non-profit institutions.
These data show the costs of labour units for care activities and support functions in the following ...

4.2 Price examples and downward pressure

Examples of prices charged
The prices charged by private psychiatric clinics are not always visible. For comparison, we can show the rates charged in the Établissement Santé Maison-Blanche, which provides mental health care for the population of Northern and Eastern Paris.
Source: ****
However, we can note significant price variations depending on ...

4.3 Diversity of the offer: the type of care structure depends on the pathology and age of the patient

The type of care depends on The type of structure

"Specialized structures: only accommodate individuals with psychiatric disorders. Most often these structures treat a wide variety of pathologies (***). An elderly individual with cognitive impairment will be accommodated in a section dedicated to patients with similar disorders in an EHPAD."
Age

"Specific ...

4.4 An evolving service offer

In order to develop the market, new care units have been created, like gerontopsychiatry (***), eating disorders, care of adolescents and young adults, perinatal disorders, overwork syndromes... The progress of the ambulatory: when private for-profit institutions didn't provide this type of service in **** (***) which is a private mental health facility offering an ...

RULES AND REGULATIONS

5.1 T2A had a significant impact on the business

One of the most significant events affecting psychiatric clinic activity was the activity-based pricing (***) for private clinics.
Its application to psychiatric institutions had been postponed to ****. Its implementation has crystallized many criticisms [***]: not all activities are valued in the same way.
If some care acts (***) are well paid, prevention or long-term ...

5.2 ARS role

Regional Health Agencies (***) are public institutions placed under the supervision of the Ministry of Health and Social Affairs.
According to Eco-santé, their role is to "ensure unified regional health management, better meet the needs of the population and increase the efficiency of the system".
ARSs can also play a role in ...

POSITIONING OF THE ACTORS

6.1 Segmentation

  • Orpéa
  • Ramsay Général de Santé
  • Inicea
  • Le Groupe Sinoué
  • Les Cliniques de Saujon
  • Clinique la Brière
  • Maison De Santé De Nogent-Sur-Marne
  • Clinique Saint-Vincent De Paul
  • Clinique Ker Yonnec

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chargé d'études économiques, Xerfi

Hugo Schott

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Associate Consultant

Mathieu Luinaud

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PhD Industrial transformations

Robin Charbonnier

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Pierre Doussau

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Arnaud Walter

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Amaury de Balincourt

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Pierrick Cudonnec

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Maelle Vitry

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Héloise Fruchard

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EDHEC

Imane Essadiq

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Vincent Defrenet

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Eva-Garance Tison

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Michela Grimaldi

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Azelie Prigent

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Cantiane Gueguen

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Jules Decour

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Alexia Vacheron

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Emil Ohlsson

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Anna Oeser

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Gabriel Salvitti

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