Fleury Marie-Josée, Perreault Michel, Grenier Guy, Imboua Armelle, Brochu Serge
Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Hospital Research Centre, Verdun, QC, Canada.
Douglas Hospital Research Centre, Montreal, QC, Canada.
Int J Integr Care. 2016 Apr 5;16(1):7. doi: 10.5334/ijic.2457.
Fragmentation and lack of coordination often occur among organisations offering treatment for individuals with substance-use disorders. Better integration from a system perspective within a network of organisations offering substance-use disorder services can be developed using various integration strategies at the administrative and clinical levels. This study aims to identify integration strategies implemented in Quebec substance-use disorder networks and to assess their strengths and limitations.
A total of 105 stakeholders representing two regions and four local substance-use disorder networks participated in focus groups or individual interviews. Thematic qualitative and descriptive quantitative analyses were conducted.
Six types of service integration strategies have been implemented to varying degrees in substance-use disorder networks. They are: 1) coordination activities-governance, 2) primary-care consolidation models, 3) information and monitoring management tools, 4) service coordination strategies, 5) clinical evaluation tools and 6) training activities.
Important investments have been made in Quebec for the training and assessment of individuals with substance-use disorders, particularly in terms of support for emergency room liaison teams and the introduction of standardised clinical evaluation tools. However, the development of integration strategies was insufficient to ensure the implementation of successful networks. Planning, consolidation of primary care for substance-use disorders and systematic implementation of various clinical and administrative integration strategies are needed in order to ensure a better continuum of care for individuals with substance-use disorders.
为患有物质使用障碍的个体提供治疗的组织之间经常出现碎片化和缺乏协调的情况。利用行政和临床层面的各种整合策略，可以在提供物质使用障碍服务的组织网络中从系统角度实现更好的整合。本研究旨在确定魁北克物质使用障碍网络中实施的整合策略，并评估其优势和局限性。
来自两个地区和四个地方物质使用障碍网络的总共105名利益相关者参与了焦点小组或个人访谈。进行了主题定性和描述性定量分析。
物质使用障碍网络中已不同程度地实施了六种类型的服务整合策略。它们是：1）协调活动——治理，2）初级保健整合模式，3）信息和监测管理工具，4）服务协调策略，5）临床评估工具和6）培训活动。
魁北克在对患有物质使用障碍的个体的培训和评估方面进行了重要投资，特别是在对急诊室联络团队的支持和引入标准化临床评估工具方面。然而，整合策略的发展不足以确保成功网络的实施。为了确保为患有物质使用障碍的个体提供更好的连续护理，需要进行规划、巩固物质使用障碍的初级保健以及系统实施各种临床和行政整合策略。
