La T2A m'a tuer

Palliative care units classified in the sector “medecine surgery obstetrics” are financed by activity rating. This financing appears advantageous but the Primary Health Insurance can carry out controls to make sure of the adequacy between the controlled stay and the care given. To do so, the doctors controllers have recommandations from the payment department. This article reports the control carried out with the palliative care unit of Saint-Malo in autumn 2009. It appears from this experience a divergence of appreciation of the concept of “palliative care” itself. Questions arise then: shall we do or work close to the recommandations of the Primary Health Insurance where the care appears to have to be systematized, or to put forward our humanistic values? Among tracks to be explored: always give sense to the care, a bringing together of palliative care professionnals and payment department in order to propose an adapted tool for these controls.