MEDICAL COORDINATION IN SAMSAH: ADDED VALUE OF PHSYCIAL AND REHABILITATION MEDECINE ?
Dr Michel DELCEYa
a SAMSAH APF
As the work of the medical coordinator remains unknown, his image is undervalued and remains attached to the elderly nursing home, the only medical and social structures in which its role is statutorily defined. What is the part played by a team at home of people experiencing disability related to neurological damage? What added value of an Physical Medicine and Rehabiliatation team (PMR) for the user when the role of this team (SAMSAH) is only the "coordination"and when it has in fact to give itself permanent limits in order not to replace other medical responders and nor to "practice" the MPR in the usual sense of the term? What is the place for such services among the pile of coordination services available to implement the trendy "care pathways"?
After a brief presentation of the intervention field and of the thirty patients included in such a program by three SAMSAH teams in the Languedoc region, we propose the review of their usual practice enhancing:
- the complexity of the situations oriented to such services, almost constantly mixing medical problems, psychological and social difficulties;
- the value of the "home care" tool reinforced by the multi professional approach,
- the importance of the links with the network of PMR resources available in the territory,
in an attempt to extract the added value of such a functional and systemic approach, specific to PMR, for patients whose care and life course is too often fragmented.
Keywords : SAMASAH, medical coordinator, home care