title: [The French Society of Geriatrics and Gerontology position paper on the concept of integration. Part two].
abstract: The concept of integrated services delivery, although dating from the 1990s, has only recently appeared in French public health policy. To clarify the concept and its adaptation to the reality of the French systems of healthcare and social services, the French Society of Geriatrics and Gerontology established an interdisciplinary working group. This article reports that group's findings according to three axes: the definition of integration, the objectives of this organizational approach and the means needed to achieve them. Analysis of the literature indicated that integration is a process that aims to overcome the fragmentation of services for vulnerable people. This process requires a multilevel approach, particularly concerning how to modify public policies and financing systems. Notably, all relevant levels need to develop shared processes, tools, resources, finance, interventions and returns on the latter. Indeed, this sharing is the ultimate proof of evolution towards integration. In the second part of the position paper, its authors have developed arguments that could lead professionals and non-professional caregivers to adopt integrated care as an answer to their aspirations. Policy-maker perspectives and politicians are also analyzed. Bearing in mind that integrated care necessarily will always involve a human component which may find expression during individual case-management; relations between integration and case managements are clarified. Finally, lessons learned from national and international experiments are examined. Results suggest that integrated care must to be accompanied by a local pilot. Results of recent experiments have shown that it is possible to initiate a dynamic towards integrated care in France and hence join the international movement towards adapting our healthcare systems to new challenges.
authors.affiliation: Université de Rennes 1, Faculté de médecine, Centre hospitalier universitaire de Rennes ; Centre de recherche sur l'action politique en Europe, UMR 6051, Rennes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Somme
authors.affiliation: Fondation nationale de gérontologie, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Trouvé
authors.affiliation: Service de gériatrie, Centre hospitalier, Mulhouse, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Passadori
authors.affiliation: ARS Languedoc-Roussillon, Montpellier, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Corvez
authors.affiliation: Service de gériatrie, Centre hospitalier universitaire, Montpellier, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Jeandel
authors.affiliation: École des hautes études en santé publique, Rennes, Sorbonne Paris Cité, équipe Management des organisations en santé (MOS), France.
authors.forename: Marie-Aline
authors.initials: MA
authors.lastname: Bloch
authors.affiliation: Délégation générale de la SFGG, Suresnes, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Ruault
authors.affiliation: Fondation Condé, Chantilly, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dupont
authors.affiliation: Service de gériatrie, APHP, Hôpital Sainte Périne, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: de Stampa
mesh_terms: D000368:Aged; D019033:Delivery of Health Care, Integrated; D005602:France; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans
keywords: concepts; coordination; definition; integrated care; position paper