International lessons from a whole system approach to integrating health and social care – PRISMA model, Quebec
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International lessons from a whole system approach to integrating health and social care – PRISMA model, Quebec

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Lindsay Kinnaird, Policy and Research Officer, Alzheimer Scotland

Lindsay Kinnaird, Policy and Research Officer, Alzheimer Scotland

Presentation from Alzheimer Scotland conference 2011 - Creating Better Dementia Care.

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International lessons from a whole system approach to integrating health and social care – PRISMA model, Quebec Presentation Transcript

  • 1. Integrated health and social care model – PRISMA, Quebec Lindsay Kinnaird Policy & Research Officer 6 June 2011
  • 2. 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
  • 3. 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
  • 4. 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
  • 5. 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
  • 6. 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
  • 7. 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
  • 8. 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
  • 9. PRISMA - population planning
    • Purpose to estimate the proportion of the population with support needs likely to:
      • Remain stable
      • Improve
      • Deteriorate
  • 10. 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
  • 11. Integrated health and social care model – PRISMA, Quebec Further information: Lindsay Kinnaird [email_address]