文章基本信息

标题：Ten years of integrated care for the older in France
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作者：Dominique Somme ; Matthieu de Stampa
期刊名称：International Journal of Integrated Care
电子版ISSN：1568-4156
出版年度：2011
卷号：11
期号：5
DOI：10.5334/ijic.668
语种：English
出版社：Utrecht University, Maastricht University, Groningen University
摘要：Background: This paper analyzes progress made toward the integration of the French health care system for the older and chronically ill population. Policies: Over the last ten years, the French health care system has been principally influenced by two competing linkage models that failed to integrate social and health care services: local information and coordination centers, governed by the social field, and the gerontological health networks governed by the health field. In response to this fragmentation, Homes for the Integration and Autonomy for Alzheimer patients (MAIAs) is currently being implemented at experimental sites in the French national Alzheimer plan, using an evidence-based model of integrated care. In addition, the state's reforms recently created regional health agencies (ARSs) by merging seven strategic institutions to manage the overall delivery of care. Conclusion: The French health care system is moving from a linkage-based model to a more integrated care system. We draw some early lessons from these changes, including the importance of national leadership and governance and a change management strategy that uses both top-down and bottom-up approaches to implement these reforms.
关键词：France ; health and social integration ; gerontology