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From the hospital to the community: reshaping the palliative care paradigm
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DOI：10.3389/fpubh.2026.1876918.png)
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Abstract
En 中文
Palliative care (PC) has traditionally developed within hospital settings; shaped by biomedical models; specialist hierarchies; and episodic care delivery. However; demographic change; rising multimorbidity; patient preferences; and health system constraints increasingly challenge hospital-centric approaches. In contrast; improving the community palliative care model requires moving beyond the simple decentralization of services toward a more integrated; person-centered; and ethically grounded system of care. At its core; an effective community model must recognize the individuality of people living with serious illness and respond to their needs across time; relationships; and care settings rather than in isolated clinical encounters. This perspective paper argues that a paradigm shift from hospital-based to community-anchored PC is no mere organizational adjustment but requires a conceptual transformation. Drawing on recent evidence and global policy frameworks; the paper explores the drivers; opportunities; and tensions of community-based PC; highlighting implications for clinical practice; professional roles; health systems; and communities. The transition between models is framed as a reorientation toward continuity; relational care; and shared responsibility; requiring new forms of integration between specialist services; primary care; and civil society.
Keywords:
community
palliative care
person-centered approach
care transition
compassionate movement
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