The health regions: varied regional approaches to this new planning space

Aim: Major parameters of French health care management and planning have been considerably modified with the policy reformentitled Hospital 2007.Aparticular emphasis has been put on the role of space. “Health territory” has become the relevant area for managementof care aiming to propose a more global approach of the health system and of the assessment of care needs. French regions have been invited to redraw the boundaries of health areas on the principles of accessibility, and continuity of care. This paper aims to analyse howregions picked up this new planning space, which concepts and methods they used to divide regional spaces and which spatial outcomes have followed.Methods: This research relies on a review of regional planning reports, laws and decrees implementing this new step in planning policy.Results: This new planning space has been differently implemented by each region. While one third of them preferred to consolidate the previous geographical division into health sectors by maintaining it, grouping sectors together or by making minor modifications, most of the regions have sought to reinvent health areas by developing new methods. These different strategies have ended up in a slight increase of the number of areas with a stronger variability of their population size.Conclusion: French regions have fairly well adopted the concepts of this new planning tool, even if some activities as psychiatry, social sector and ambulatory care have been insufficiently taken into account in the health areas construction. These different conceptionsof health area make now question their management.