title: Integrated service delivery networks for seniors: early perceptions of family physicians.
abstract: OBJECTIVE
  To document the early perceptions of family physicians regarding integrated service delivery (ISD) networks a few weeks before and 6 months after establishing these networks and to identify obstacles to using case managers.
  
  
  METHODS
  Cross-sectional survey with two questionnaires mailed 6 months apart.
  
  
  METHODS
  Three regional municipalities (one urban and two rural) in the Eastern Townships of Quebec.
  
  
  METHODS
  All family physicians in the three areas (n = 267). A total of 124 physicians (of 206 eligible; 60% response rate) answered the first questionnaire, and 104 of these the second (86% response rate).
  
  
  METHODS
  The first questionnaire asked what family physicians thought about ISD networks and the emerging case management function, and whether they were interested in participating in ISD networks. The second measured physicians' participation in ISD networks, asked whether their perceptions of case management had changed, and identified obstacles to using case managers.
  
  
  RESULTS
  Nearly all (98%) respondents to the preimplementation questionnaire believed that family physicians will increasingly have to belong to ISD networks. Very few (8.2%), however, felt involved or consulted in decisions about developing and implementing these networks. More than one quarter (27%) did not know that an ISD network for older people would be established in their area, and 84.3% did not feel sufficiently informed to be involved. Most family physicians (85.7%) said they were interested in using case managers. Six months after implementation, 70.2% of physicians knew that case managers were available; 35.6% had used a case manager. During implementation, physicians' opinions about case management were slightly less positive than they had been. The three main obstacles to using case managers were forgetting to use them (69.1%), the habit of using social workers instead (63.6%), and not knowing how to contact them (59.4%).
  
  
  CONCLUSIONS
  Physicians are interested in participating in ISD networks and working with case managers. They must be better informed, however, about the availability of case managers, how they can reach case managers, case managers' precise role, and the advantages to themselves and their patients of using these services.
authors.affiliation: Research Centre on Aging, Sherbrooke, QC.
authors.forename: Linda
authors.initials: L
authors.lastname: Milette
authors.forename: Réjean
authors.initials: R
authors.lastname: Hébert
authors.forename: Anne
authors.initials: A
authors.lastname: Veil
mesh_terms: D000328:Adult; D000368:Aged; D019090:Case Management; D019058:Community Networks; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011792:Quebec