How Primary Healthcare Sector is Organized at the Territorial Level in France? A Typology of Territorial Structuring

Author:

Gautier Sylvain12ORCID,Josseran Loïc12

Affiliation:

1. Research Center in Epidemiology and Population Health, Primary Care and Prevention Team, Inserm U1018, Université Paris-Saclay, UVSQ, Villejuif, France.

2. Department of Hospital Epidemiology and Public Health, Raymond Poincaré Hospital, GHU Université Paris-Saclay, AP-HP, Garches, France.

Abstract

Background: Most the Organization for Economic Co-operation and Development (OECD) countries are currently facing the challenges of the health transition, the aging of their populations and the increase in chronic diseases. Effective and comprehensive primary healthcare (PHC) services are considered essential for establishing an equitable, and cost-effective healthcare system. Developing care coordination and, on a broader scale, care integration, is a guarantee of quality healthcare delivery. The development of healthcare systems at the meso-level supports this ambition and results in a process of territorial structuring of PHC. In France, the Health Territorial and Professional Communities (HTPC) constitute meso-level organizations in which healthcare professionals (HCPs) from the same territory gather. We conducted a study to determine, in a qualitative step, the key elements of the territorial structuring of PHC in France and, then, to develop, in a quantitative step, a typology of this structuring. Methods: A sequential-exploratory mixed-method study with a qualitative step using a multiple case approach and a quantitative step as a hierarchical clustering on principal components (HCPC) from a multiple correspondence analysis (MCA). Results: A total of 7 territories were qualitatively explored. Territorial structuring appears to depend on: past collaborations at the micro-level, meso-level coordination among HCPs and multiprofessional structures, diversity of independent professionals, demographic dynamics attracting young professionals, and public health investment through local health contracts (LHCs). The typology identifies 4 clusters of mainland French territories based on their level of structuring: under or unstructured (38.6%), with potential for structuring (34.7%), in the way for structuring (25.3%) and already structured territories (1.4%). Conclusion: Interest in territorial structuring aligns with challenges in meso-level healthcare organization and the need for integrated care. Typologies of territorial structuring should be used to understand its impact on access, care quality, and medical resources.

Publisher

Maad Rayan Publishing Company

Reference69 articles.

1. Meslé F, Vallin J. [From epidemiological transition to health transition]. Med Trop (Mars) 2007;67(6):545-551. [French].

2. OECD. Health at a Glance 2023: OECD Indicators. Paris: OECD Publishing; 2023. https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2023_7a7afb35-en. Accessed February 14, 2024.

3. Towards a values framework for integrated health services: an international Delphi study

4. Europe’s Strong Primary Care Systems Are Linked To Better Population Health But Also To Higher Health Spending

5. Multiple Perspectives Analysis of the Implementation of an Integrated Care Model for Older Adults in Quebec

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3