Organizing the public health-clinical health interface: theoretical bases. 2006

Michèle St-Pierre, and Daniel Reinharz, and Jacques-Bernard Gauthier
Faculté des sciences de l'administration, Département de management, Pavillon Palasis-Prince, Université Laval, Québec, G1K 7P4, Canada. Michele.St-Pierre@mng.ulaval.ca

This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities.

UI MeSH Term Description Entries
D007373 Interinstitutional Relations The interactions between representatives of institutions, agencies, or organizations. Interagency Relations,Interagency Relation,Interinstitutional Relation,Relation, Interagency,Relation, Interinstitutional,Relations, Interagency,Relations, Interinstitutional
D011634 Public Health Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. Community Health,Environment, Preventive Medicine & Public Health,Environment, Preventive Medicine and Public Health,Health, Community,Health, Public
D011635 Public Health Administration Management of public health organizations or agencies. Administration, Public Health
D011792 Quebec A province of eastern Canada. Its capital is Quebec. The region belonged to France from 1627 to 1763 when it was lost to the British. The name is from the Algonquian quilibek meaning the place where waters narrow, referring to the gradually narrowing channel of the St. Lawrence or to the narrows of the river at Cape Diamond. (From Webster's New Geographical Dictionary, 1988, p993 & Room, Brewer's Dictionary of Names, 1992, p440)
D006285 Health Planning Planning for needed health and/or welfare services and facilities. Health and Welfare Planning,National Health Planning and Resources Development Act of 1974,Planning, Health and Welfare,State Health Planning, United States,PL93-641,Public Law 93-641,Planning, Health,Public Law 93 641
D006304 Health Status The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. General Health,General Health Level,General Health Status,Level of Health,Overall Health,Overall Health Status,General Health Levels,Health Level,Health Level, General,Health Levels,Health Status, General,Health Status, Overall,Health, General,Health, Overall,Level, General Health,Levels, General Health,Status, General Health,Status, Health,Status, Overall Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015510 Clinical Medicine The study and practice of medicine by direct examination of the patient. Medicine, Clinical
D019033 Delivery of Health Care, Integrated A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7) Integrated Delivery Systems,Integrated Health Care Systems,Delivery System, Integrated,Delivery Systems, Integrated,Integrated Delivery System,System, Integrated Delivery,Systems, Integrated Delivery
D019058 Community Networks Organizations and individuals cooperating together toward a common goal at the local or grassroots level. Community Care Networks,Community Health Networks,Care Network, Community,Care Networks, Community,Community Care Network,Community Health Network,Community Network,Health Network, Community,Health Networks, Community,Network, Community,Network, Community Care,Network, Community Health,Networks, Community,Networks, Community Care,Networks, Community Health

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