Long-stay inpatients in short-term emergency units in France: A case study.

Lacking any conventional definition, the phenomenon of so-called "bed-blockers" concerns the issue of long-stay inpatients in short-term units. Our paper explores this question in the context of French Emergency Rooms (ERs) and focuses not on "bed-blocking" as a patient phenomenon but rather on the social constructs developed around these patients by ER professionals. In this paper, we present a case study on one of these "bed-blockers" and venture some hypotheses regarding this phenomenon. On the one hand, it appears as a dysfunction in the healthcare system. Indeed, French ERs take on patients that specialized medical units are reluctant to admit, either because they do not fit into any one specific scientific or clinical category, or because they are not "profitable" when analyzed using care-management tools. On the other hand, bed-blockers play an important role in building a positive identity for the French emergency doctors and personnel performing the "dirty work" of treating them. Copyright 2009 Elsevier Ltd. All rights reserved.