[Coordination of support to general practitioners to facilitate the patient's care pathway]

In France, the referring GP is responsible for coordination of the patient's care pathway, but GPs appear to have few resources to achieve this task A general practitioner support network (Arespa) was developed in the Franche-Comté region (Arespa)for complex patients.

To analyse the functioning and effects, of this network on the GP's practices.

Qualitative research. Material based on individual semistructured interviews of members of Arespa staff and regulatory bodies; collective interviews of all coordinators (12; 4 groups) and general practitioners (37, 7 groups). Clinical vignettes were used to determine the nature of the coordinators' work; the doctor's perception of the network and how and why they used it; the perceived impact of the network; but also regulation byfunding bodies.

This coordinating network can be considered to be an original case management organisation, as it addresses the consequences of the disease on the patient's everyday life in order to facilitate the care pathway and life. The main differences are that it is primarily directed to GPs and coordinator interventions may therefore focus on treatment the consequences of disease rather than the patient's expectations. Secondly, there are no eligibility criteriafora patient's entitlement toArespa intervention, which depends exclusively on each doctor's assessment.

This approach is part of a specific institutional and regulatoryframework designed to ensure the use and individual and collective efficacy of the Arespa network. The authors discuss the results in the light of the literature on case management.