International Journal of Integrated Care, 31 December 2009 - ISSN 1568-4156
Conference abstract
PRISMA in Québec and France: implementation and impact of a coordination-type integrated service delivery (ISD) system for frail older people
Réjean Hébert, MD, MPhil, Dean, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12è avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada
Suzanne Durand, GA, MSc, DBA (cand), Professor, Unité d'enseignement et de recherche en sciences de la gestion, Université du Québec en Abitibi-Témiscamingue, 445, boul. de l'Université, Rouyn-Noranda, Québec, J9X 5E4, Canada
Dominique Somme, MD, PhD, Service de Gériatrie-Pôle Urgence Réseaux, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc, 75908 Paris Cedex 15, France
Michel Raîche, MSc, PhD (cand), Research Center on Aging, CSSS-IUG of Sherbrooke, 1036, Belvédère Sud, Sherbrooke, Québec, J1H 4C4, Canada
Correspondence to: Réjean Hébert, Phone: +1-819-564-5201, Fax: +1-819-564-5420, E-mail:; Suzanne Durand, Phone: +1-819-762-0971 ext 2696, E-mail:; Dominique Somme, Phone: (+33) 1 56 09 27 26, Fax: (+33) 1 56 09 38 21, E-mail:; Michel Raiche, Phone: +1-819-821-1170 ext 45652, Fax: +1-819-829-7141, E-mail:

Introduction: Several models of integrated service delivery (ISD) networks are presently experimented in Canada and elsewhere, but most of them are designed according to a full integration model (PACE, S-HMO, SIPA). PRISMA is the only example of a coordinated-type model to be developed and fully implemented with a process and outcome evaluation.

The PRISMA model includes the following components to enhance the integration: 1) co-operation between decision-makers and managers of all services and institutions, 2) the use of a single entry point, 3) case management process, 4) individualized service plans, 5) a unique disability-based assessment tool (SMAF) with a case-mix system (Iso-SMAF profiles) and case-finding tool (PRISMA-7), and 6) a computerized system for communicating between institutions and professionals.

The PRISMA model: The PRISMA model was implemented in three areas (urban, rural with or without a local hospital) in Québec, Canada and research was carried out using both qualitative and quantitative data to evaluate its process and impact. An efficiency study was carried out, considering societal costs and all population impacts.

Based on the population impact demonstration, the PRISMA model has also been adapted and implemented in France. This symposium will present the implementation, impact and efficiency of the Québec experimentation, and the implementation transfer in France.

PRISMA model; integrated service delivery

Presentation slides