Deployment and core elements of the outpatient palliative care day hospital model

Early palliative care has driven outpatient models, yet palliative care day hospitals (PCDHs) are poorly described. Defining their core components and landscape is crucial for future evaluation.

A national cross-sectional survey (Jan-May 2024) identified adult PCDH programmes across France. A nominal group comprising high-activity and diverse centres then defined intervention components, structured via the American Heart Association taxonomy.

38 PCDH programmes were identified. Most were in urban areas (81.5%) and operated an average of 3.3 days per week, seeing 2 patients per day. Only 32.4% were part of a palliative care unit or hospice. A core team-palliative physician and nurse-managed care in 68.4% of centres. Services included symptom management, advance care planning, interventional procedures and non-pharmacological therapies. The final taxonomy described eight domains, outlining key components of PCDH structure, staffing, interventions and outcomes. It reflects the complexity and multidisciplinary nature of palliative day hospital care.

This first national census maps the organisational diversity and core elements of PCDHs in France, establishing a structured basis for future evaluation. These findings lay the groundwork for future evaluation, with the next step to assess how adaptable and effective current PCDH models are in palliative care.