{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:52:56Z","timestamp":1791298376615,"version":"4.1.0"},"reference-count":10,"publisher":"CAIRN.INFO","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:p>Introduction\u00a0: La performance hospitali\u00e8re est traditionnellement \u00e9valu\u00e9e par la corr\u00e9lation positive entre le volume d\u2019entr\u00e9es et le taux d\u2019occupation des lits. Les donn\u00e9es hospitali\u00e8res marocaines de\u00a02023 r\u00e9v\u00e8lent une rupture de ce paradigme\u00a0: un record historique d\u2019admissions (1\u00a0211\u00a0765 patients) concomitant \u00e0 un effondrement du taux d\u2019occupation moyen (TOM) \u00e0 56,6\u00a0%. Dans ce contexte, cette \u00e9tude vise \u00e0 analyser \u00e9conom\u00e9triquement les d\u00e9terminants de ce \u00ab\u00a0d\u00e9couplage\u00a0\u00bb paradoxal afin de d\u00e9terminer si la baisse de l\u2019occupation rel\u00e8ve d\u2019une inefficience ou d\u2019une mutation du mod\u00e8le productif, tout en explorant l\u2019h\u00e9t\u00e9rog\u00e9n\u00e9it\u00e9 structurelle du syst\u00e8me. M\u00e9thodes\u00a0: Une \u00e9tude longitudinale r\u00e9trospective (2016\u20132023) a \u00e9t\u00e9 men\u00e9e sur les donn\u00e9es d\u2019hospitalisation compl\u00e8te du minist\u00e8re de la Sant\u00e9 (Sant\u00e9 en Chiffres 2023). Un mod\u00e8le de r\u00e9gression lin\u00e9aire multiple sur donn\u00e9es standardis\u00e9es a permis de quantifier le poids respectif des admissions, de la capacit\u00e9 liti\u00e8re et de la dur\u00e9e moyenne de s\u00e9jour (DMS) sur la variation du TOM. R\u00e9sultats\u00a0: L\u2019analyse confirme un effet de ciseaux majeur en\u00a02023. La mod\u00e9lisation (R 2 = 0,793) montre que la DMS constitue un d\u00e9terminant structurel majeur (\u03b2 = +\u00a00,79), dont la r\u00e9duction drastique \u00e0 3,5\u00a0jours a neutralis\u00e9 l\u2019effet haussier du volume d\u2019admissions (\u03b2 = +\u00a00,95). L\u2019analyse d\u00e9sagr\u00e9g\u00e9e met en \u00e9vidence un syst\u00e8me \u00e0 deux vitesses\u00a0: les CHU fr\u00f4lent la saturation (TOM &gt; 70\u00a0%, DMS de 6 \u00e0 8\u00a0jours), tandis que les h\u00f4pitaux provinciaux pr\u00e9sentent une sous-utilisation des capacit\u00e9s et des rotations tr\u00e8s rapides (DMS de 1 \u00e0 3\u00a0jours). Conclusion\u00a0: L\u2019h\u00f4pital public marocain semble \u00e9voluer vers une logique de \u00ab\u00a0flux tendu\u00a0\u00bb, rendant l\u2019indicateur classique du taux d\u2019occupation moins pertinent pour appr\u00e9cier la performance globale. Toutefois, cette efficience technique apparente masque des disparit\u00e9s importantes et impose une vigilance accrue quant \u00e0 la qualit\u00e9 des soins, notamment face au risque de r\u00e9admissions li\u00e9 \u00e0 des sorties cliniques de plus en plus pr\u00e9coces.<\/jats:p>","DOI":"10.3917\/spub.263.0215","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:30:45Z","timestamp":1791297045000},"page":"215-225","source":"Crossref","is-referenced-by-count":0,"title":["D\u00e9couplage entre flux d\u2019admissions et taux d\u2019occupation dans les h\u00f4pitaux publics marocains (2016\u20132023)\u00a0: analyse \u00e9conom\u00e9trique du r\u00f4le d\u00e9terminant de la dur\u00e9e de s\u00e9jour"],"prefix":"10.3917","volume":"vol. 38","author":[{"given":"Aazelarab","family":"Boughaleb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounir","family":"Jerry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2273","reference":[{"key":"rb1","unstructured":"1. Lorenzoni L, Marino A. Understanding variations in hospital length of stay and cost : results of a pilot project. OECD Health Working Papers No. 94. Paris : OECD Publishing ; 2017."},{"key":"rb2","unstructured":"2. Minist\u00e8re de la Sant\u00e9 et de la Protection Sociale. Sant\u00e9 en chiffres 2023 [en ligne]. Rabat : Direction de la planification et des ressources financi\u00e8res ; 2024. [Visit\u00e9 le 01\/10\/2025]. Disponible sur : https:\/\/www.sante.gov.ma\/Documents\/2025\/01\/Sante%20en%20chiffre%202023%20VF.pdf."},{"key":"rb3","unstructured":"3. Haut-Commissariat au plan (HCP). Les indicateurs sociaux du Maroc : \u00e9dition 2024. Rabat : Royaume du Maroc ; 2024. pp. 153\u2013158."},{"key":"rb4","unstructured":"4. Centre Hospitalo-Universitaire Mohammed VI. Rapport d\u2019activit\u00e9 2020-2021-2022. Marrakech : Minist\u00e8re de la Sant\u00e9 et de la Protection Sociale ; 2023. pp. 18\u201321."},{"key":"rb5","unstructured":"5. Eurostat. Hospital discharges and length of stay statistics [en ligne]. Statistics Explained ; 2024. [Visit\u00e9 le 01\/10\/2025]. Disponible sur : https:\/\/ec.europa.eu\/eurostat\/statistics-explained\/index.php?title=Hospital_discharges_and_length_of_stay_statistics\/index.php?title=Hospital_discharges_and_length_of_stay_statistics."},{"key":"rb6","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2016.00417"},{"key":"rb7","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2019.06.006"},{"key":"rb8","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-021-01373-2"},{"key":"rb9","doi-asserted-by":"publisher","DOI":"10.5812\/healthscope-136089"},{"key":"rb10","doi-asserted-by":"publisher","DOI":"10.1016\/j.mex.2025.103208"}],"container-title":["Sant\u00e9 Publique"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:30:48Z","timestamp":1791297048000},"score":1,"resource":{"primary":{"URL":"https:\/\/stm.cairn.info\/revue-sante-publique-2026-3-page-215?lang=fr&ref=doi"}},"subtitle":[""],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.3917\/spub.263.0215","relation":{},"ISSN":["0995-3914"],"issn-type":[{"value":"0995-3914","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}