international lessons from a whole system approach to integrating health and social care – prisma...
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Lindsay Kinnaird, Policy and Research Officer, Alzheimer ScotlandPresentation from Alzheimer Scotland conference 2011 - Creating Better Dementia Care.TRANSCRIPT
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Integrated health and social care model – PRISMA, Quebec
Lindsay KinnairdPolicy & Research Officer
6 June 2011
Integrated health and social care model - PRISMA, Quebec
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Integration central to Scottish health and social care policy agenda
Audit Scotland report on Community Health Partnerships
Reshaping Care for Older People and Change Fund
Scottish National Dementia Strategy
Integrated health and social care model - PRISMA, Quebec
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Integration in Quebec
Since 1970s, Quebec has continued to implement a regional structure to coordinate and integrate health and social care
However, many factors have impeded effective service delivery and integration, including:
Lack of adequate investment by government in regional structures
Organisational complexity
Integrated health and social care model - PRISMA, Quebec
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Correlation between Scotland and Quebec
Publicly funded health system founded at time when population was younger and to respond to mainly acute conditions
Older population will make-up an increasing proportion of total population; rise in long-term conditions
Integrated health and social care model - PRISMA, Quebec
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PRISMA model
Developed in Eastern Townships of Quebec from 1997 to 2007
Model specific to local circumstances; where access to services controlled and information can be shared locally
Whilst not transferable wholesale, impact on wider system and elements being adopted throughout Quebec
Two specific elements may provide lessons for Scotland
Integrated health and social care model - PRISMA, Quebec
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PRISMA model
Case finding tool – to identify those with potential health and social care needs previously unknown to health care system
Population planning – to anticipate and plan for increasing needs
Integrated health and social care model - PRISMA, Quebec
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PRISMA - case finding tool
Resource pressures and difficulty accessing services; however,
Identifying level and type of population needs viewed as essential to determining who receives support
Integrated health and social care model - PRISMA, Quebec
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PRISMA - case finding tool
Questionnaire developed from literature review of risk factors for functional decline and tested to measure success in identification of those at risk
Identify those with potential disability who should undergo a comprehensive assessment of support needs
Opportunistic and systematic approach used in local community services and primary health centres
Rationale - identify cases to avoid postponement of diagnosis and escalation in health problems
Integrated health and social care model - PRISMA, Quebec
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PRISMA - population planning
Purpose to estimate the proportion of the population with support needs likely to:
Remain stable
Improve
Deteriorate
Integrated health and social care model - PRISMA, Quebec
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PRISMA - population planning
Data from single assessment tool used to identify those with similar characteristics
From this cluster sampling used to identify care groups – 14 groups identified
Population planning based on current circumstances and estimating the proportion likely to remain stable, improve or their condition deteriorate
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Integrated health and social care model – PRISMA, Quebec
Further information:Lindsay Kinnaird