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Conference Papers Year : 2023

Boundaries Issues related to Local Implementation of Dedicated Coordination Schemes in four Policy Areas in France

Abstract

In France, as in many other countries, health and social care is fragmented. Two types of policies have been undertaken to reduce this fragmentation and improve health and social care coordination – policies creating dedicated coordination schemes, and policies reconfiguring the health and social care systems’ organisation and governance. Both health care (primary versus hospital care) and long term care for older or disabled people are concerned. Analysis of four policy areas – primary care, mental health, care for older people and care for disabled people – shows a marked acceleration of these policies since the mid-2010. We propose to analyse the process of local implementation of various coordination schemes created since 2015 in a twofold way: ● Their reception and implementation by local institutional and professional actors: Regional Health Agencies, Local Authorities and professionals from local health and social care organisations piloting those coordination schemes. How do national policies and local dynamics interact? How do they punctuate the implementation process? ● The negotiations and arbitrations related to the organisational settings of the schemes: how local geographical and administrative territories and shared responsibilities for territorial and clinical coordination were reconfigured? Our first results show that the implementation of dedicated coordination schemes induces boundary reshaping processes highly constrained by structural conditions and pre-existing dynamics. Results and further analysis are based on exploratory survey (October-December 2022) and the first wave of semi-directive interviews (n=15, January-May 2023) as part of a research project about the implementation of dedicated coordination schemes at the local level in France.
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Dates and versions

hal-04554525 , version 1 (22-04-2024)

Identifiers

  • HAL Id : hal-04554525 , version 1

Cite

Alis Sopadzhiyan, Deborah Ridel. Boundaries Issues related to Local Implementation of Dedicated Coordination Schemes in four Policy Areas in France. 6th Transforming Care Conference TCC, Transforming Care Network, Jun 2023, Sheffield, Royaume-Uni. ⟨hal-04554525⟩
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