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The healthcare pathway and care for people with multiple disabilities in Italy and Norway

Rousseau M.C., Humbertclaude E., Lauksecker C., Dagois JF., Billette de Villemeur T.

Éthique et santé.2019; 16(3): 100-110. https://doi.org/10.1016/j.etiqe.2019.06.005

Summary

Introduction

Polydisability (PLH) is defined as the combination of a profound mental deficiency and a severe motor deficit resulting in an extreme reduction in autonomy. In France, the healthcare system is based on inpatient, medical/social and outpatient care. This health pathway is not always optimal and can lack fluidity. Other models of care pathways for these patients exist in Norway and Italy, where disabled people are cared for outside institutions.

Method

A multi-disciplinary group of French experts in the field went to Norway and Italy to observe the healthcare pathways of multi-disabled patients outside institutions, and to identify areas for improvement that could be transposed to France.

Comparing healthcare systems

The strengths of the Norwegian model lie in the fact that families are supported in compensating for the consequences of their loved one’s disability, and in the transfer of skills to local players. The strengths of the Italian coordinated care pathway are that it provides patients with a rapid, coordinated and ongoing response to every medical problem. These two models provide potentially inspiring solutions for our care system, which attempts to answer both the political and clinical ethical questions raised by these extremely vulnerable people.