Canada: Application of a Coordinated-Type Integration Model for Vulnerable Older People in Québec: The PRISMA Project

Réjean Hébert ()
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Réjean Hébert: Université de Montréal

Chapter 30 in Handbook Integrated Care, 2017, pp 499-510 from Springer

Abstract: Abstract Several models of Integrated Service Delivery (ISD) networks were experimented and tested, but most of them are designed according to a full integration model. PRISMA is the only example of a coordinated-type model to be developed and fully implemented with a process and outcome evaluation. The PRISMA model includes the following components to enhance the integration: (1) co-operation between decision-makers and managers of all services and organizations, (2) the use of a single entry point with a case-finding instrument (PRISMA-7), (3) a case management process, (4) Individualized Service Plans, (5) a unique disability-based assessment tool (SMAF) with a case-mix system (Iso-SMAF profiles), and (6) a computerized system for communicating between institutions and professionals. The PRISMA model was experimentally implemented in three areas (urban, rural with or without a local hospital) in Quebec, Canada and research was carried out using both qualitative and quantitative data to evaluate its process and impact. The impact study was population-based with a quasi-experimental design. The experimental group presented a difference of 6.3% on functional decline prevalence (p = 0.03). The incidence of new cases of functional decline was also significantly lower by 1.4%. Satisfaction and empowerment were significantly higher (both p

Date: 2017
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DOI: 10.1007/978-3-319-56103-5_30

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