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Integrated care for older people in France in 2020: findings, challenges, and prospects
- Authors:
- BAJEUX Emma, CORVOL Aline, SOMME Dominique
- Journal article citation:
- International Journal of Integrated Care, 21(S2), 2021, p.16. Online only
- Publisher:
- International Foundation for Integrated Care
Background: We analyze here major changes over the last decade in the French healthcare system for older people, in terms of the integrated care concept. Policies: During this period, the major theme of public policies was “care coordination.” Despite some improvements, the multiplication of experimental programs and the multiplicity of stakeholders distanced the French healthcare system from an integrated care model. Professionals and organizations generally welcomed these numerous programs. However, most often, the programs were insufficiently implemented or articulated, notably at a clinical level, because of the persistence of a high level of fragmentation of governance, despite the creation of regional health agencies 10 years ago. The COVID-19 crisis has highlighted this fragmentation. Moreover, we still lack data on the impact of these programs on people’s health trajectories and personal experiences. Conclusion: The French healthcare system seems more fragmented in 2020 than in 2010, despite improvements in the culture of professional collaboration. The future health reform is an opportunity to capitalize upon this progress and to implement “integrated care.” This implies a strong and continuous national leadership in governance and change management. (Edited publisher abstract)
Ageing populations and housing needs: comparing strategic policy discourses in France and England
- Authors:
- HILLCOAT-NALLETAMBY Sarah, et al
- Journal article citation:
- Social Policy and Administration, 44(7), December 2010, pp.808-826.
- Publisher:
- Wiley
There is a broad European policy agenda which promotes ‘ageing in place’, where older people are helped to live independently in their own homes in familiar local environments. Placing independent living and ‘aging in place’ on the policy agenda means that housing will need to become a more central element of welfare agendas. This article compares recent English and French policy discourses on population ageing and its implications for the housing needs of increasingly large numbers of older citizens. Through analysis of 6 recent strategic policy statements representing each government's official responses to population ageing and its social policy implications for the 21st century, the article demonstrates how differences in the social representation of the ageing process and of older people themselves permeate policy discourse, influencing the perceptions of the housing needs of older citizens and the role that housing itself may play in promoting independent living. In England, demographic ageing, housing and its role in facilitating independent living and active ageing are explicitly articulated, whilst in France, the housing environment has until recently, been portrayed as one which must accommodate the illness, incapacity and dependency of later life. This article offers explanations for these differences in terms of cultural variations in the social representations of later life, divergences in political philosophies and welfare principles.
The development of integration in the elderly care sector: a qualitative analysis of national policies and local initiatives in France and Sweden
- Author:
- SOPADZHIYAN Alis
- Journal article citation:
- Ageing and Society, 39(5), 2019, pp.1022-1049.
- Publisher:
- Cambridge University Press
Due to a significant increase in the complexity of the care demands of older people having multiple care needs, the necessity for integrated care is increasingly acknowledged. Proposing a qualitative approach based on a secondary literature analysis and an empirical survey, this paper explores the integration policy of health and social care for older people having complex needs in two European countries – France and Sweden – where various policy measures aiming at developing and delivering integrated care can be identified: at the national level, through the supportive measures of organisational, institutional and/or professional integration from central government, and at the local level, with the implementation of concrete integrative initiatives. Using a comparative qualitative approach, the authors investigate both of these levels, as well as the interplay between them. They show the importance of this double – local and national – approach of the issue of integration and highlight the continuous negotiation process which underlies the integration activities. Local integration initiatives are in fact constantly reshaped by top-down and bottom-up dynamics which appear to be strongly interconnected. (Publisher abstract)
Long term care policies in Italy, Australia and France: variations in cash-for-care schemes
- Author:
- Da ROIT Barbara
- Journal article citation:
- Social Policy and Administration, 41(6), December 2007, pp.653-671.
- Publisher:
- Wiley
Cash benefit provisions have been at the core of many recent reforms in the long-term care sector in Europe. The respective schemes, however, vary widely in terms of the definition of entitlements, the level of benefits, and the ways in which benefits can be used by recipients. This article investigates cash-for-care schemes in three European social insurance countries. It asks whether the diversity of these schemes indicates different paths or just differences in the pace with which the respective policies address the risk of dependency. A characterization of the three schemes and a discussion of the implications for care work arrangements lead to the conclusion that the context and timing of long-term care reform processes are in fact quite variegated. All three countries have histories of cash schemes and of applying the cash approach to support – and to some extent relieve – traditionally strong family obligations. Differences predominate in terms of linking cash to employment, although some convergence is apparent in the effects on qualifications, working conditions and wages in care work.