Introduction: The fragmentation of the French health and services system has a negative impact on the quality of the services offered because dependant community-dwelling older persons receive services from a mean of three interveners, and 25% of the most dependent ones perceive assistance from at least 6 interveners. In 2006, the Ministry of Health funded an experimentation of implantation of an evidence-based model of integration based on case management: PRISMA.
Aims and objective: An implementation evaluative research was associated with the experimentation undertaken by an international (France, Quebec) and multidisciplinary (medical doctors, sociologists, economists) group of research.
Methods: This evaluation is carried out continuously all along the implementation process. It is essentially based on research-action framework. A multi-case qualitative analysis is performed on three sites contrasted in regard of the health and services local organisation: rural, urban and megalopolitan.
Results: Initial implementation seems to be low during the first 18 months. First objective signs of integration after 12 months were the emergence of a coordination process on a strategic level, the adoption of a unique assessment tools by all the partners and the project of constituting a multi-professional team of case managers. Sociological and political identified barriers will be discussed.
Presentation slides available from: http://www.integratedcarenetwork.org/Sweden2008/slides/01-03-somme.ppt