The PRISMA France study: implementation rate and factors influencing this rate
International Journal of Integrated Care, 31 December 2009 - ISSN 1568-4156
Poster abstract
The PRISMA France study: implementation rate and factors influencing this rate
Dominique Somme, MD, PhD, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
Hélène Trouvé, PhD, National Foundation of Gerontology, University of Paris Pantheon Sorbonne, Paris, France
Francis Etheridge, PhD (c), Research center on aging, University of Sherbrooke, Sherbrooke, Québec, Canada
Dominique Gagnon, PhD (c), Research center on aging, University of Sherbrooke, Sherbrooke, Québec, Canada
Yves Couturier, PhD, Research center on aging, University of Sherbrooke, Sherbrooke, Québec, Canada
Fréderic Balard, PhD, National Foundation of Gerontology, Paris, France
Olivier Saint-Jean, MD, PhD, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
Correspondence to: Dominique Somme, E-mail: dominique.somme@egp.aphp.fr
Abstract


Introduction: The PRISMA integration model is a promising method to implement integration in health and social services for elderly people. In the PRISMA-France study, we qualitatively studied the implementation process of this model in French settings.


Method: Our analyses were based on in-depth interviews, meeting observations and the documentation produced.


Results: We adapted the implementation scale inherent to the PRISMA model to fit the French context and, using this scale, were able to appreciate a 15% progression of implementation, from 5% to 20%, in the first 18 months of the study. The factors that contributed to this rate of progression are of three main types. To begin with, contextual factors intrinsic to the French setting complexified the incorporation of integration into the public policy agenda and the means to achieve this feat. Secondly, factors related to the background of the concerned managers and professionals were identified. Thirdly, factors related to the particularities of the PRISMA-Experiment's governance were noted. Our experience leads to consider time as the answer to these hindering contextual, professional and governance issues.


Conclusion: These observations hold an important strategic value in a time where a wider integration experimentation is planned by the ‘plan-Alzheimer’ in France.

Keywords
integration measurement; factors influencing implementation; integrated health care networks; France