Conocimiento y uso de mecanismos de coordinación clínica de servicios de salud de Latinoamérica

Andrea Estefania Miranda Mendizabal, Ingrid Vargas Lorenzo, Amparo Susana Mogollon Perez, Marina Ferreira de Madeiros, Isabela Samico, Pamela Eguiguren, Julieta López, Fernando Bertolotto, Delia Amarilla, María Luisa Vázquez

Research output: Contribution to journalResearch Articlepeer-review

12 Scopus citations


© 2018 SESPAS Objective: To analyze the level of knowledge and use, and the characteristics of use, of care coordination mechanisms in public healthcare networks of six Latin America countries. Method: Cross-sectional study based on a survey using the COORDENA® questionnaire with primary and secondary care doctors (348 doctors/country) of public healthcare networks in Argentina, Brazil, Chile, Colombia, Mexico and Uruguay (May-October 2015). Analyzed variables: degree of knowledge and use of information coordination (referral/reply letter, discharge report, phone, e-mail) and of clinical management coordination (shared clinical guidelines, joint meetings) mechanisms. Descriptive analyses were conducted. Results: Knowledge of clinical information coordination mechanisms was high in both care levels and analyzed networks as was the use of referral/reply letter. There was greater variability in the use of discharge reports (from 40.0% in Brazil to 79.4% in Mexico) and, except for Argentina, a low reception reported by primary care doctors stands out (12.3% in Colombia and 55.1% in Uruguay). In contrast, knowledge of clinical management coordination mechanisms was limited, especially among secondary care doctors. It is noteworthy, however, that adherence to clinical guidelines was high (from 83.1% in Mexico to 96.8% in Brazil), while participation in joint meetings varied widely (from 23.7% in Chile to 76.2% in Brazil). The difficulties reported in the use of the mechanisms are related to structural and organizational factors. Conclusions: The limited knowledge and use of coordination mechanisms shows insufficient diffusion and implementation. Strategies to increase its use are needed, including the related factors.
Translated title of the contributionConocimiento y uso de mecanismos de coordinación clínica en redes de servicios de salud de Latinoamérica
Original languageEnglish (US)
Pages (from-to)340-349
Number of pages9
JournalGaceta Sanitaria
Issue number4
StatePublished - Jul 1 2020


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