Article
French
ID: <
10670/1.i6djkz>
Abstract
International audience In a context of scarce resources, rationalizing health care has become imperative. At the same time, hospitals emphasize the difficulties in managing end-of-life patients and encourage palliative practices. We studied in a thesis how these two rationales are articulated and sought to assess the integration of hospital palliative care teams in the rationalization process. The first part of the work presents the current situation of hospital palliative care: while this activity is recognized as a national priority, its modalities of development and of financial backing are subject to criticism. The second part of the work presents a general framework for the economic analysis of palliative care: (1) the characteristics of patients being cared for, the nature of continuity of care and the costs associated with hospital stays were studied, and the major dimensions for the patients were identified; (2) two alternative funding models to those currently used are discussed: a model of hospital days weighted by the type of care and a model of annual fixed budgets.