68. Canada: Application of a Coordinated-Type Integration Model for Vulnerable Older People in Québec—The PRISMA Project

The chapter delves into the PRISMA project in Québec, Canada, which focuses on integrating health and social services for vulnerable older people. Key topics include the development and implementation of a coordinated-type integration model, the evaluation of the model's impact on service delivery and patient outcomes, and the challenges and lessons learned from the project. The PRISMA model comprises six components: coordination between decision-makers and managers, a single entry point, case management, individualized service plans, a single assessment instrument, and a computerized clinical chart. The model was implemented in three regions of the Eastern Townships in Québec and was subject to rigorous evaluation. The results showed a reduction in functional decline, unmet needs, and health services utilization in the experimental group. However, the wider dissemination of the model was slowed by structural reforms and budget restrictions. The chapter concludes with lessons learned and recommendations for future implementation of integrated care models.