Le système de santé français à l’épreuve des transitions

• Main Author: Laurent Chambaud
• Format: Article
• Language: English
• Published: Les Éditions de la Maison des Sciences de l’Homme 2016-05-01
• Series: Socio
• Subjects: health system; transitions; a shift in paradigm; health problems; integrated health care
• Online Access: http://journals.openedition.org/socio/2300

This article focuses on the concept of “integrated care” conveyed in the concept of “integrated healthcare and services” which is tending to become the norm in the literature on studies concerning health, illness and health care. This concept, which could be compared to the concept of standard care pathways advocated at the moment in France, helps us to go beyond the usual separation between cure and care, healthcare and assistance. Its implementation is based on an ongoing shift in paradigm on the basis of a phenomenon of transition combining five spheres: epidemiological transition—with the chronic aspect of the majority of serious illnesses; the demographic transition which promotes the concept of service to the individual, prevention/cure, support; professional transition which involves young health professionals; technological transition, which is not specific to the world of health but where it is implemented, for example in the use of the technologies which challenge the care provisions or the detection processes; democratic transition, of which one finds antecedents in the rights of patients in the years 2000, and during the emergence of new concepts like the patient-expert or therapeutical education. The issues at stake and the obstacles to this evolution in our health system are discussed.