The development of palliative care services in France (1987-2013)

Aim. - Our study aimed to monitor the development of palliative care services in France between 1987 and 2013 and to examine the geographical distribution of these services overtime. Methods. - We conducted a meta-analysis of published data and ``grey literature'' to obtain reliable estimates for the years 1987, 1993, 1997, 2001, 2003, 2005, 2007, 2008, 2010, 2012 and 2013. Results. - Between 1987 and 2013, the number of palliative care units increased from six to 130, resulting in an increase from 150 to 1412 palliative care unit beds. In addition, 431 hospital palliative care support teams were installed in hospital facilities. The number of palliative care beds has increased from 232 to 4663 between 2001 and 2004. Finally, home-based palliative care support teams have been widely developed since 1997, although we noticed a decrease in their number between 2010 and 2013. However, despite this significant development of palliative care services in France, regional discrepancies have increased over time. Conclusion. - Considering the extent and the nature of current palliative care needs at the population level, France's national end-of-life care strategy should shift from a ``palliative care service'' vision to an ``integrated palliative care'' perspective. (C) 2015 Elsevier Masson SAS. All rights reserved.