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Theses

Les équipes hospitalières de soins palliatifs dans le processus de rationalisation des soins : entre engagement idéologique et contraintes financières.

Abstract : In a context of scarce resources, rationalizing health care has become imperative. At the same time, the hospitals emphasize the difficulties in managing the end of life and palliative practices are being encouraged. We studied how these two logics are articulated and sought to assess the integration of hospital palliative care teams in the rationalization process. The first part of the thesis 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 critiques and the financial logic appears to have gained supremacy over the humanitarian logic. The second part of the thesis presents a general framework for the economic analysis of palliative care. 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. Two alternative funding models to those currently used are also discussed: a model of hospital days weighted by the type of care and a model of annual fixed budgets.
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https://tel.archives-ouvertes.fr/tel-00351978
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Submitted on : Monday, January 12, 2009 - 12:12:53 PM
Last modification on : Thursday, September 1, 2022 - 11:06:58 AM
Long-term archiving on: : Tuesday, June 8, 2010 - 7:30:08 PM

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  • HAL Id : tel-00351978, version 1

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Yaël Tibi-Lévy. Les équipes hospitalières de soins palliatifs dans le processus de rationalisation des soins : entre engagement idéologique et contraintes financières.. Sciences de l'Homme et Société. Université Paris Sud - Paris XI, 2007. Français. ⟨tel-00351978⟩

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