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The development of integration in the elderly care sector: a qualitative analysis of national policies and local initiatives in France and Sweden

Published online by Cambridge University Press:  26 December 2017

BLANCHE LE BIHAN*
Affiliation:
French School of Public Health (EHESP), Rennes, France.
ALIS SOPADZHIYAN
Affiliation:
French School of Public Health (EHESP), Rennes, France.
*
Address for correspondence: Blanche Le Bihan, Department of Social Sciences, French School of Public Health (EHESP), Avenue du Professeur Léon Bernard, CS 74312–35043 Rennes Cedex, France E-mail: Blanche.Lebihan@ehesp.fr

Abstract

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.

Type
Article
Copyright
Copyright © Cambridge University Press 2017 

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