En France, si la médecine de groupe tend à augmenter, elle reste moins développée que dans d’autres pays, notamment dans les disciplines cliniques de premiers recours comme la médecine générale, qualifiées à l’étranger de « soins primaires ». Dans l’objectif d’éclairer la situation française, la situation du regroupement des médecins généralistes a été analysée dans six pays européens et deux provinces canadiennes.

Dans les pays où la médecine de groupe est majoritaire (Finlande, Pays-Bas, Royaume-Uni, Suède, Québec et Ontario), les processus de regroupement et les modes d’exercice des médecins sont variés. En Suède et en Finlande, le regroupement s’opère dans des structures publiques locales avec des équipes multidisciplinaires, tandis qu’au Canada, aux Pays-Bas et au Royaume-Uni, il s’organise dans des structures privées gérées par des professionnels de santé indépendants dans un cadre contractuel. Les pays où la médecine de groupe est minoritaire (Allemagne, Belgique et Italie) se dirigent pour la plupart, comme c’est le cas pour la France, vers un exercice plus collectif de la médecine générale.

Les politiques incitant au regroupement des médecins généralistes s’accompagnent le plus souvent de pratiques nouvelles : mécanismes d’inscription volontaire des patients auprès d’un médecin en groupe, coopération entre professions de santé, modification de la rémunération des médecins, etc. L’importance de la place accordée aux soins primaires dans chaque pays, de même que l’évolution de la demande et de l’offre de soins à partir des années quatre-vingt-dix, semblent constituer des déterminants importants du regroupement.

Source IRDES

Health issues are a vital concern for older adults, and surveys show that most of those who go online search for health and medical information. However, since only 34 percent of people age 65 and older are online, the majority of older adults are missing out on valuable health information. To broaden the numbers of older adults able to search for and find reliable health information online, the National Institute on Aging (NIA) has developed a free training curriculum for those who teach and work with older adults. This Toolkit for Trainers is now available on NIHSeniorHealth.gov, a senior-friendly Web site developed by the NIA and the National Library of Medicine (NLM), components of the National Institutes of Health (NIH).

"Research has shown that age is no hindrance to computer or Internet use. But proper training is important to build computer confidence and Internet skills in older people," says Richard J. Hodes, M.D., NIA director. "This training program is designed to open up the Internet to older adults who want to know more about the health issues facing them as they age."

The Toolkit for Trainers can be a welcome addition to computer training programs at public libraries, senior centers, community colleges, and lifelong learning centers, places where older adults typically take computer courses. Instructors at these locations can use the curriculum to teach older adults how to find accurate, up-to-date online health information on their own. To make sure the training curriculum meets the learning needs of older adults, NIA developers based its design on cognitive aging and vision research and field tested the materials with older adults and instructors in computer classes.

In addition to Web skills development, the easy-to-use curriculum focuses on top-notch health and wellness information offered by NIHSeniorHealth and MedlinePlus. NIHSeniorHealth features short, easy-to-read segments of information that can be accessed in a variety of formats, including various large-print type sizes, open-captioned videos and an audio version. MedlinePlus is NLM's more detailed site for consumer health information.

Trainers who download the toolkit at www.nihseniorhealth.gov/toolkit <http://www.nihseniorhealth.gov/toolkit>  will receive a set of materials they can customize to their students' skill levels and interests. These include lesson plans, student handouts, Web searching exercises and illustrated glossaries. An introductory video gives a quick overview of the curriculum and a glimpse of Internet classes in action. Tips on how to set up a senior-friendly computer classroom also are provided

The NIA leads the federal effort supporting and conducting research on aging and the health and well-being of older people.

The NLM, the world's largest library of the health sciences, creates and sponsors Web-based health information resources for the public and professionals.

NIH -- The Nation's Medical Research Agency -- includes 27 institutes and centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov <http://www.nih.gov/> .