Les Hôpitaux de Jour et Centres d'Accueil Thérapeutiques à Temps Partiel (CATTP) sont des structures alternatives à l'hospitalisation qui visent à favoriser l'insertion ou le maintien du patient dans son environnement familial, social, éducatif ou professionnel. Si leur intérêt est bien reconnu, il n'en reste pas moins que ces structures sont encore peu étudiées dans leur spécificité, au plan de leur fonctionnement global en termes d'organisation, de moyen, d'activité. L'Agence Régionale de l'Hospitalisation a lancé une étude exhaustive en deux temps (1998 puis 2000) en Ile-de-France visant à mieux connaître ces établissements. Au total 207 structures adultes (10 663 patients adultes) et 150 structures infanto-juvéniles (4 199 enfants/adolescents) ont été enquêtées. L'étude montre en quoi, malgré leurs files actives sensiblement équivalentes, les CATTP et les Hôpitaux de Jour diffèrent dans leur fonctionnement. En ce qui concerne les patients, les facteurs déterminants de différenciation des structures sont relatifs à l'âge et à la pathologie. Enfin, pour un groupe de patients ayant le même type de pathologie et des caractéristiques communes, la prise en charge est plus intensive en hôpital de jour qu'en CATTP, particulièrement en hôpital de jour non sectorisé.

Day care hospitals and Centres d'Accueil Thérapeutiques à Temps Partiel (Part-Time Treatment Centres, CATTP) are structures that offer an alternative to hospitalisation. Day care hospitals provide a wide range of intense, personalised care, during daytime, with the aim of optimising the patients' insertion or maintenance into their family, social or professional milieus. To do so, these hospitals offer psychological, sociological, therapeutic and educational actions, as well as accompaniment. CATTP are structures whose aim is to encourage an autonomous existence by means of support groups and group therapy. Their management of patients is more occasional and they offer small groups of patients a variety of activities within a well-defined and regular framework. Although their utility has been recognised, there have nevertheless been few studies conducted on these structures regarding their global operation in terms of organisation, means and activity. There have also been few studies on the difference between day care hospitals and CATTP. The Agence Régionale de l'Hospitalisation d'Île-de-France (Regional Agency for Hospitalisation in Ile de France) launched a two-phase exhaustive study in 1998 and then 2000. The aim of the study was to better understand the care given, and types of management offered, in these structures in Ile de France. It is a large, descriptive, transversal study based on exhaustive questionnaires sent to the structures. The questionnaires were composed of a administrative form and a patient form. In total, 207 adult structures (10,663 adult patients) and 150 infant-youth structures (4,199 children/adolescents) were surveyed. The study shows that in addition to a more discontinuous management in CATTP than in day care hospitals for essentially an equivalent number of active files, the number of sessions is lower and there is less full-time staff present. Non-sector day care hospitals have a wider variety of staff than sector day care hospitals, which are characterised by a predominance of nursing staff. The discontinuous operating method of CATTP is even more marked in infant-youth psychiatry, and the operating differences between sector day care hospitals and non sector day care hospitals is also greater in this field than in adult psychiatry. As far as the patients are concerned, the factors determining the differentiation between structures concern age and pathology. Finally, for a group of patients with the same type of pathology and common characteristics, management is more intense in day care hospitals than in CATTP, particularly in non-sector day care hospitals. As regards the modalities for discharge from these structures, they seem to depend simultaneously on structural limits (age) and the autonomy and severity of the patients' pathology.