a1 Solidage, Groupe de recherche Université de Montréal–Université McGill sur les services intégrés aux personnes âgées
The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and health care programs, which in Canada are still fragmented. SIPA (Services intégrés pour les personnes âgées fragiles) is an integrated service model based on community services, a multidisciplinary team, case management that retains clinical responsibility for all the health and social services required, and the capacity to mobilize resources as required and according to the care protocol. The SIPA demonstration project used an experimental design, with random allocation of the 1,230 participants from two areas of Montreal to an experimental and a control group. The costs of institutional services were $4,270 less for those in the SIPA group compared to the control group; the costs of community care were $3,394 more. The proportion of persons waiting in acute care hospitals for nursing home placement was twice as high in the control group as in the SIPA group. The costs of acute hospitalizations for persons in the SIPA group with ADL disabilities were at least $4,000 lower than those for persons in the control group. In conclusion, the SIPA trial showed that it is possible to undertake ambitious and rigorous demonstration projects in Canada. These results were obtained without an increase in the overall costs of health and social services, without reducing the quality of care, and without increasing the burden on elderly persons and their relatives.
(Received November 25 2004)
(Accepted November 03 2005)
c1 Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : François Béland, Département d'administration de la santé, Faculté de Médecine, Université de Montréal, CP 6128, Succ. Centre-Ville, Montréal, QC H3C 3J7. (email@example.com)
* Cette recherche a été rendue possible grâce au financement de la Fondation canadienne sur la recherche en services de santé, les Instituts de recherche en santé du Canada, le Fonds d'adaptation des services de santé, le Ministére de la Santé et des Services sociaux du Québec, la Régie régionale de la Santé et des Services sociaux de Montréal-Centre et le CLSC Bordeaux-Cartierville.