Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries

Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in thi...

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Autores Principales: Vázquez, María-Luisa, Vargas, Ingrid, Garcia-Subirats, Irene, Unger, Jean-Pierre, De Paepe, Pierre, Mogollon-Pérez, Amparo Susana, Samico, Isabella, Eguiguren, Pamela, Cisneros, Angelica-Ivonne, Huerta, Adriana, Muruaga, María-Cecilia, Bertolotto, Fernando
Formato: Artículo (Article)
Lenguaje:Inglés (English)
Publicado: 2017
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Acceso en línea:http://repository.urosario.edu.co/handle/10336/18787
id ir-10336-18787
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spelling ir-10336-187872019-09-19T12:37:54Z Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries Vázquez, María-Luisa Vargas, Ingrid Garcia-Subirats, Irene Unger, Jean-Pierre De Paepe, Pierre Mogollon-Pérez, Amparo Susana Samico, Isabella Eguiguren, Pamela Cisneros, Angelica-Ivonne Huerta, Adriana Muruaga, María-Cecilia Bertolotto, Fernando Care Coordination Care Integration Health Services Research Health-Care Surveys Integrated Delivery Systems Latin America Primary Health Care Quality Of Health Care Atención primaria en salud Administración de servicios de salud Administración hospitalaria Health Services Health Survey Health Worker Latino People Perception Public Health Argentina Brazil Chile Colombia Consultation Coordination Cross-Sectional Study Doctor Patient Relation Employment Follow Up General Practitioner Health Care Survey Health Services Research Human Logistic Regression Analysis Mexico Model Patient Care Perception Questionnaire Salary Satisfaction Secondary Health Care Skill Uruguay Argentina Brazil Chile Colombia Mexico [North America] Uruguay Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in this region. This paper analyses the level of clinical coordination between PC and SC experienced by doctors and explores influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was carried out based on a survey of doctors working in the study networks (348 doctors per country). The COORDENA questionnaire was applied to measure their experiences of clinical management and information coordination, and their related factors. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between general perception of care coordination and associated factors. With some differences between countries, doctors generally reported limited care coordination, mainly in the transfer of information and communication for the follow-up of patients and access to SC for referred patients, especially in the case of PC doctors and, to a lesser degree, inappropriate clinical referrals and disagreement over treatments, in the case of SC doctors. Factors associated with a better general perception of coordination were: being a SC doctor, considering that there is enough time for coordination within consultation hours, job and salary satisfaction, identifying the PC doctor as the coordinator of patient care across levels, knowing the doctors of the other care level and trusting in their clinical skills. These results provide evidence of problems in the implementation of a primary care-based model that require changes in aspects of employment, organization and interaction between doctors, all key factors for coordination. © 2017 The Authors 2017 2018-12-10T14:45:10Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion ISSN0277-9536 http://repository.urosario.edu.co/handle/10336/18787 eng info:eu-repo/semantics/openAccess application/pdf Aller, M.B., Vargas, I., Coderch, J., Calero, S., Cots, F., Abizanda, M., Development and testing of indicators to measure coordination of clinical information and management across levels of care (2015) BMC Health Serv. Res., 15, p. 323
institution EdocUR - Universidad del Rosario
collection DSpace
language Inglés (English)
topic Care Coordination
Care Integration
Health Services Research
Health-Care Surveys
Integrated Delivery Systems
Latin America
Primary Health Care
Quality Of Health Care
Atención primaria en salud
Administración de servicios de salud
Administración hospitalaria
Health Services
Health Survey
Health Worker
Latino People
Perception
Public Health
Argentina
Brazil
Chile
Colombia
Consultation
Coordination
Cross-Sectional Study
Doctor Patient Relation
Employment
Follow Up
General Practitioner
Health Care Survey
Health Services Research
Human
Logistic Regression Analysis
Mexico
Model
Patient Care
Perception
Questionnaire
Salary
Satisfaction
Secondary Health Care
Skill
Uruguay
Argentina
Brazil
Chile
Colombia
Mexico [North America]
Uruguay
spellingShingle Care Coordination
Care Integration
Health Services Research
Health-Care Surveys
Integrated Delivery Systems
Latin America
Primary Health Care
Quality Of Health Care
Atención primaria en salud
Administración de servicios de salud
Administración hospitalaria
Health Services
Health Survey
Health Worker
Latino People
Perception
Public Health
Argentina
Brazil
Chile
Colombia
Consultation
Coordination
Cross-Sectional Study
Doctor Patient Relation
Employment
Follow Up
General Practitioner
Health Care Survey
Health Services Research
Human
Logistic Regression Analysis
Mexico
Model
Patient Care
Perception
Questionnaire
Salary
Satisfaction
Secondary Health Care
Skill
Uruguay
Argentina
Brazil
Chile
Colombia
Mexico [North America]
Uruguay
Vázquez, María-Luisa
Vargas, Ingrid
Garcia-Subirats, Irene
Unger, Jean-Pierre
De Paepe, Pierre
Mogollon-Pérez, Amparo Susana
Samico, Isabella
Eguiguren, Pamela
Cisneros, Angelica-Ivonne
Huerta, Adriana
Muruaga, María-Cecilia
Bertolotto, Fernando
Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
description Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in this region. This paper analyses the level of clinical coordination between PC and SC experienced by doctors and explores influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was carried out based on a survey of doctors working in the study networks (348 doctors per country). The COORDENA questionnaire was applied to measure their experiences of clinical management and information coordination, and their related factors. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between general perception of care coordination and associated factors. With some differences between countries, doctors generally reported limited care coordination, mainly in the transfer of information and communication for the follow-up of patients and access to SC for referred patients, especially in the case of PC doctors and, to a lesser degree, inappropriate clinical referrals and disagreement over treatments, in the case of SC doctors. Factors associated with a better general perception of coordination were: being a SC doctor, considering that there is enough time for coordination within consultation hours, job and salary satisfaction, identifying the PC doctor as the coordinator of patient care across levels, knowing the doctors of the other care level and trusting in their clinical skills. These results provide evidence of problems in the implementation of a primary care-based model that require changes in aspects of employment, organization and interaction between doctors, all key factors for coordination. © 2017 The Authors
format Artículo (Article)
author Vázquez, María-Luisa
Vargas, Ingrid
Garcia-Subirats, Irene
Unger, Jean-Pierre
De Paepe, Pierre
Mogollon-Pérez, Amparo Susana
Samico, Isabella
Eguiguren, Pamela
Cisneros, Angelica-Ivonne
Huerta, Adriana
Muruaga, María-Cecilia
Bertolotto, Fernando
author_facet Vázquez, María-Luisa
Vargas, Ingrid
Garcia-Subirats, Irene
Unger, Jean-Pierre
De Paepe, Pierre
Mogollon-Pérez, Amparo Susana
Samico, Isabella
Eguiguren, Pamela
Cisneros, Angelica-Ivonne
Huerta, Adriana
Muruaga, María-Cecilia
Bertolotto, Fernando
author_sort Vázquez, María-Luisa
title Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
title_short Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
title_full Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
title_fullStr Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
title_full_unstemmed Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
title_sort doctors' experience of coordination across care levels and associated factors. a cross-sectional study in public healthcare networks of six latin american countries
publishDate 2017
url http://repository.urosario.edu.co/handle/10336/18787
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score 10,755503