Implementing an evidence-based integration model in France to maintain independence: Project and Research on Integration of Services to Maintain the Autonomy (PRISMA)
International Journal of Integrated Care, 4 June 2008 - ISSN 1568-4156
Conference abstract
Implementing an evidence-based integration model in France to maintain independence: Project and Research on Integration of Services to Maintain the Autonomy (PRISMA)
D. Somme, University of Paris 5, France
H. Trouvé, PhD, Clinical Research Unit, Georges Pompidou European Hospital, Paris, France
Y. Couturier, Sherbrooke University, Canada
D. Gagnon, PhD, Sherbrooke University, Canada
S. Carrier, PhD, Sherbrooke University, Canada
O. Saint-Jean, University of Paris 5, France
R. Hébert, Sherbrooke University, Canada
Correspondence to: Dominique Somme. E-mail: dominique.somme@egp.aphp.fr
Abstract


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.

Keywords
care for the elderly; qualitative research; France

Presentation slides available from: http://www.integratedcarenetwork.org/Sweden2008/slides/01-03-somme.ppt