[PASS units: mechanisms for delivering healthcare to underserved populations. The example of the Hôtel-Dieu PASS, Paris].

The 1998 French law on combating exclusion established PASS units (Permanences d'Accès aux Soins de Santé, or Healthcare Access Points) to guarantee access to healthcare for all, including people in precarious situations. PASS centers aim to address the social, economic, administrative, and linguistic barriers that prevent vulnerable populations from accessing the healthcare system.This article provides an overview of how PASS operate in France and describes the PASS at Hôtel-Dieu in Paris (Public Hospitals of Paris). This PASS offers patients a holistic approach that includes medical care, psychiatric follow-up, social support, interpretation services, and specialized consultations.As of 2023, there were 451 PASS centers in France. The Hôtel-Dieu PASS, with its multidisciplinary team, carried out over 10,500 medical consultations for 4,144 patients. Most users are young male migrants without health insurance (69%) or stable housing (nearly 90%). The most common conditions are chronic diseases (e.g., hypertension and diabetes), infectious diseases (e.g., hepatitis B/C, HIV, and tuberculosis), and mental health issues (e.g., post-traumatic stress disorder and anxiety).The Hôtel-Dieu example illustrates the specific features of PASS centers: accessibility without appointments, single locations and time slots, and adaptability to precarious schedules. These services enable vulnerable populations to reconnect with the healthcare system. However, their effectiveness depends on long-term funding, enhanced medical and social coordination, and institutional recognition of their role.PASS units respond to an ethical and public health imperative: caring for those furthest from the healthcare system. Their sustainability requires adequate human and financial resources. They must remain places of innovation, welcome, and inclusion that constantly adapt to social, political, and migratory changes.