Intégrer la prévention dans les soins primaires : avant tout un enjeu organisationnel.

ABSTRACT

INTRODUCTION: The health needs of the population are changing and the health care system must adapt to meet them. In France, the need for prevention is significant and recognized. Yet the shift toward prevention is struggling to take hold in primary care, and prevention indicators remain low. PURPOSE OF THE RESEARCH This article presents the developments and challenges involved in integrating prevention into primary care. It is based on three leading French reports on the subject. RESULTS: Prevention and health promotion initiatives are described as poorly organized, being based on individual and opportunistic initiatives. In particular, this is due to the difficulty of integrating a collective, long-term dimension into preventive clinical practices, even though most preventive situations require a coordinated, repeated approach that is integrated intothe care offered. At the same time, the primary care system is being structured around coordinated practice. These organizational changes are opportunities to integrate prevention into the practices of primary care professionals. CONCLUSIONS: A great deal depends on successfully integrating prevention into the structuring and organizational evolution of the primary care system. The convergence of the operationalization of the preventive shift and the organizational transformation of the primary care system is potentially synergistic for the integration of prevention. But this development is not self-evident and must be accompanied by precise, up-to-date, and contextualized knowledge of the factors influencing the practice of prevention.