results of the project mapéru : care of alzheimer’s disease in rural areas mickaël blanchet...
TRANSCRIPT
Results of the project Mapéru : Care of Alzheimer’s disease in rural areas
Mickaël Blanchet
Scientific Council of Fondation Plan Alzheimerjeudi 9 janvier 2014 -Paris
Advisor : Professor Christian Pihet, University of AngersRealization : Mickaël Blanchet, Post-doctorate, University of Angers
Summary :
A- Before the Mapéru project
B- Context, objectives, territories of study and methodology
C- Results :
Detection and diagnosis of Alzheimer’s disease in rural areas
Territorialization and development of policies of Alzheimer on territories
Local care of Alzheimer’s disease : professional coordination and interactions
with informals caregivers and patients
C- Conclusion, perspectives and future project
Interactions
-Access to detection and diagnosis
-Deployment and territorialization of Alzheimer’s Policies
- Local care of the Alzheimer’s disease in rural areas
Spatial distribution of patients and their needs Geography
Alzheimer policies
Location of target areas and age demographics within those areas
Source : INSEE RGP [email protected]
Map localization of departement of study
West rural territories of study
East rural territories of study
• Epidemiologic, demographic, medical and social survey completed by a mapping work
• Interviews with institutions : Regional Agences of Health and General Councils (9)
•Interviews with professionals localized on target areas (32)
•Interviews with the main caregivers (30)
Methodology :
Epidemiologic extrapolation
PAQUID cohort (Dartigues, from 1988
until present)
Eurodem Synthesis
(Hofman and al, 1991)
Medical data available
Drugs consummation
Long disease category
source : National health insurance
Census of patients in :
-Hospital
- Old people’s home medicalized
- Nursing home service
- Services of orientation
All the departments of study
All rural territories of study
Unequal rates on territories Gap
C-Results• Territorialization and development of Alzheimer’s policies on
territories
regulate
Regional Agency of Health (HPST Law, in application since 2011)
• Fusion of medical and medico-social sectors
• Principles of contractualization and concurrence
• Intention to adapt services to individuals needs
Third Plan Alzheimer 2008-2012
• Research development
• Development and specialization of the offers of services
• Attention to informals caregivers
• Creation of MAIA : new device for professional coordination
1- A strengthening of Regional Agency of Health
2- A better efficiency and cooperation on territories
3- Unequal deployment of Alzheimer’s care services on territories
Location of sites specialized care sites for Alzheimer's disease in the departments and target areas(2013)
sources : DREES, mission pilotage Plan Alzheimer, INSEE, 2008
Kind of services specialized on Alzheimer’s careTypes of services specialized in Alzheimer’s
care
C-Results• Local care of Alzheimer’s disease : professional coordination
and interactions between professionals, informals caregivers
and patients
Dependence Allocation
Social home help
Nursing Home
Accomodate places for days/nights
Temporary Home
Allocation dependance
+ Health funds (Ald
15)
Social home help
Nursing Home
Medical equipment
Home adaptation
High level of resort Low level of resort
disease progression
no resort to allocation
Social home help
Nursing Home
number of case : 13 number of case : 7
number of case : 4
++
+
• The gap between cohorts, datas of health national insurance and local
census in rural areas
• The role of general practicionner and family’s proximity for the diagnosis
time spent in rural areas
• New health policies with paradoxal effects
• The inadequacy in rural areas of the local answers for the care become
extensive
Conclusion :
Thank you for your attention
Mickaël Blanchet