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Hélène Trouvé

Bio: Hélène Trouvé is an academic researcher from University of Paris. The author has contributed to research in topics: Public policy & Health care. The author has an hindex of 8, co-authored 21 publications receiving 250 citations.

Papers
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Journal ArticleDOI
TL;DR: People suffering from dementia are particularly vulnerable to the gaps between the health and social service systems, and case management is a professional field that seeks to fill in these gaps.
Abstract: Background People suffering from dementia are particularly vulnerable to the gaps between the health and social service systems. Case management is a professional field that seeks to fill in these gaps and remedy this fragmentation. Methods We report the results of a systematic literature review of the impact of case management programs on clinical outcomes and the utilization of resources by persons with dementia. We focused on randomized controlled trials (RCTs) and attempted to identify the factors that might contribute to greater program efficacy. Because the evaluation methods in these studies varied, we used the effect size method to estimate the magnitude of the statistically significant effects reported. Results Our search strategy identified 17 references relating to six RCTs. Four of these six RCTs reported moderately statistically significant effects (effect size, 0.2–0.8) on their primary end point: the clinical outcome in three and resource utilization in one. Two of the RCTs reported weak or no effects (effect size, Conclusions Integration and case management intensity seem to determine the magnitude of the clinical effects in this new professional field. Further studies are needed to clarify the economic impact.

121 citations

Journal ArticleDOI
TL;DR: Using path dependency as an analytical framework helps to understand the reasons why institutional integration is critical to organizational and clinical integration, and the complex construction of institutional integration in France.
Abstract: Background : The literature on integration indicates the need for an enhanced theorization of institutional integration. This article proposes path dependence as an analytical framework to study the systems in which integration takes place. Purpose : PRISMA proposes a model for integrating health and social care services for older adults. This model was initially tested in Quebec. The PRISMA France study gave us an opportunity to analyze institutional integration in France. Methods : A qualitative approach was used. Analyses were based on semi-structured interviews with actors of all levels of decision-making, observations of advisory board meetings, and administrative documents. Results : Our analyses revealed the complexity and fragmentation of institutional integration. The path dependency theory, which analyzes the change capacity of institutions by taking into account their historic structures, allows analysis of this situation. The path dependency to the Bismarckian system and the incomplete reforms of gerontological policies generate the coexistence and juxtaposition of institutional systems. In such a context, no institution has sufficient ability to determine gerontology policy and build institutional integration by itself. Conclusion : Using path dependence as an analytical framework helps to understand the reasons why institutional integration is critical to organizational and clinical integration, and the complex construction of institutional integration in France.

29 citations

Journal ArticleDOI
TL;DR: The analysis of the context of implementation of the innovation which represents integration in the field of health and services for frail older reveals obstacles and favourable conditions.
Abstract: Background The French health and services system to maintain at home is characterized by its fragmentation, whereas the need of the people for intervention is generally total. This fragmentation have consequences: delay in services delivery, inadequate transmission of information, redundant evaluation, service conditioned by the entrance point solicited rather than by the need of the person and inappropriate use of expensive resources by ignorance or difficulty of access to the less expensive resources. Presentation of the innovation The purpose of integration is to improve continuity of interventions for people in loss of autonomy. It consists in setting up a whole of organisational, managerial and clinical common tools. Organisational model “Projet et Recherches sur l’Integration des Services pour le Maintien de l’Autonomie” (Prisma) tested in Quebec showed a strong impact on the prevention of the loss of autonomy in term of public health on a population level. This model rests on six principal elements: partnership, single entry point, case-management, a multidimensional standardized tool for evaluation, an individualized services plan and a system for information transmission. Contextual analysis Thus, it was decided to try to implement in France this organisational model. The project is entitled Prisma France and is presented here. The analysis of the context of implementation of the innovation which represents integration in the field of health and services for frail older reveals obstacles (in particular because of diversity of professional concerned and a presentiment of complexity of the implementation of the model) and favourable conditions (in particular the great tension towards change in this field). Conclusion The current conditions in France appear mainly favourable to the implementation of integration. The establishment of Prisma model in France requires a partnership work of definition of a common language as well on the diagnoses as on the solutions. The strategic and operational dialogue is thus a key element of the construction of integration. This stage currently occurs in parallel in three areas contrasted in France. The results of associated qualitative research should make it possible to define the factors fostering or hindering the realization of integration according to each site (analyzes contrasted) and in all the sites (related to the particular context of care and French services as a whole).

24 citations

Journal ArticleDOI
TL;DR: The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.
Abstract: The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.

13 citations

Book
01 May 2006
TL;DR: The notion of utilite sociale emerged sur la scene publique dans un contexte de delegation par l'Etat de certaines missions and services d'interet general.
Abstract: "La notion d'utilite sociale a emerge sur la scene publique dans un contexte de delegation par l'Etat de certaines missions et services d'interet general. Si la notion a donne matiere a polemiques, tant dans les debats sociopolitiques qu'academiques, deux grandes interpretations predominent : d'une part, l'utilite sociale des activites associatives fonde leur legitimite vis-a-vis de leurs partenaires et de l'opinion publique, d'autre part, elle peut offrir aux acteurs associatifs l'opportunite de s'interroger sur le sens de leurs interventions en (re)definissant leurs propres valeurs et finalites. L'organisation d'une journee d'etude entierement consacree a cette thematique a ete l'occasion de proceder a un etat des lieux de la recherche, en reunissant des jeunes chercheurs d'horizons disciplinaires varies (sociologie, economie, sciences politiques, geographie et urbanisme). Les articles rassembles dans cet ouvrage abordent les formes variees de reconfiguration de l'action publique sous des eclairages a la fois theoriques et empiriques. Mobilisee dans des champs d'activite aussi divers que la protection de l'environnement, les biotechnologies agricoles, la lutte contre le Sida, en passant par le commerce equitable et le secteur sportif, l'utilite sociale ne peut faire l'objet d'une definition univoque et consensuelle. Cette notion multidimensionnelle sert ainsi de prisme pour saisir les nouvelles caracteristiques de l'action publique caracterisees simultanement : par une co-construction des politiques publiques entre secteur associatif et pouvoirs publics, par l'elaboration de modes de regulation publique de l'action associative, par la transformation des modes d'engagement associatif sous l'effet d'une professionnalisation accrue et par une forte territorialisation des interventions menees au nom de l'utilite sociale. Au fil de l'ouvrage, un constat s'impose : l'enjeu apparait moins dans la recherche d'une definition universelle que dans l'identification, toujours contextualisee, des finalites poursuivies par les differents protagonistes."

13 citations


Cited by
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Journal ArticleDOI
TL;DR: The Lancet Commission on Dementia Prevention, Intervention, and Care met to consolidate the huge strides that have been made and the emerging knowledge as to what the authors should do to prevent and manage dementia.

3,826 citations

21 Sep 2016
TL;DR: Current dementia healthcare services are over-specialised, and that a rebalancing is required with a more prominent role for primary and community care, to increase capacity, limit the increased costs associated with scaling up coverage of care and improve the coordination and integration of care.
Abstract: The World Alzheimer Report 2016, Improving healthcare for people living with dementia: Coverage, quality and costs now and in the future, reviews research evidence on the elements of healthcare for people with dementia, and, using economic modelling, suggests how it should be improved and made more efficient. The report argues that current dementia healthcare services are over-specialised, and that a rebalancing is required with a more prominent role for primary and community care. This would increase capacity, limit the increased costs associated with scaling up coverage of care, and, coupled with the introduction of care pathways and case management, improve the coordination and integration of care. Modelling of the costs of care pathways was carried out in Canada, China, Indonesia, Mexico, South Africa, South Korea and Switzerland, to estimate the costs of dementia healthcare under different assumptions regarding delivery systems. The report was researched and authored by Prof Martin Prince, Ms Adelina Comas-Herrera, Prof Martin Knapp, Dr Maelenn Guerchet and Ms Maria Karagiannidou from The Global Observatory for Ageing and Dementia Care, King’s College London and the Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science.

858 citations

BookDOI
08 Nov 2016
TL;DR: The report examines the prevalence and nature of family caregiving of older adults as well as the impact of caregiving on caregivers’ health, employment, and overall well-being and assesses available evidence on the effectiveness of programs, supports, and other services designed to support family caregivers.
Abstract: Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

629 citations

01 Jan 2010
TL;DR: In this article, the authors explore the many definitions, concepts, logics and methods found in health system and service integration, and summarize the main elements or building blocks of integrated care and suggest a way to address its various complexities and unknowns in a real world sense.
Abstract: Integrated care is a key strategy in reforming health systems around the world. Despite its importance, the concept's polymorphous nature and lack of specificity and clarity significantly hamper systematic understanding, successful application and meaningful evaluation. This article explores the many definitions, concepts, logics and methods found in health system and service integration. In addition to framing this evolving, albeit imprecise field, the article summarizes the main elements or building blocks of integrated care and suggests a way to address its various complexities and unknowns in a real-world sense.

310 citations

04 Sep 2013
TL;DR: Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version.
Abstract: Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.

232 citations