Changes in knowledge and use of clinical coordination mechanisms between care levels in healthcare networks of Colombia

Heisel Gloria León-Arce; Amparo Susana Mogollón-Pérez; Ingrid Vargas; María Luisa Vázquez

doi:10.1002/hpm.3073

Changes in knowledge and use of clinical coordination mechanisms between care levels in healthcare networks of Colombia

Título traducido de la contribución: Cambios en el conocimiento y uso de los mecanismos de coordinación clínica entre niveles asistenciales en las redes de salud de Colombia

Heisel Gloria León-Arce
, Amparo Susana Mogollón-Pérez
, Ingrid Vargas
, María Luisa Vázquez

Producción científica: Contribución a revista › Artículo de Investigación › revisión exhaustiva

8 Citas (Scopus)

Resumen

Los mecanismos de coordinación clínica (MCC) se han convertido en herramientas clave en las redes asistenciales para mejorar la coordinación entre la atención primaria (AP) y la atención secundaria (APS) y son especialmente relevantes en sistemas de salud con una provisión sanitaria muy fragmentada. Sin embargo, su implementación ha sido poco estudiada hasta la fecha en América Latina y particularmente en Colombia. Este estudio analiza el nivel de conocimiento y uso de los MCP entre niveles asistenciales y sus cambios entre 2015 y 2017 en dos redes públicas de salud en Bogotá, Colombia. Comparación de dos estudios transversales basados en encuestas a médicos de AP y CS que trabajan en sus redes (174 médicos por red/año). Se utilizó el cuestionario COORDENA para medir el conocimiento sobre MCP y la frecuencia de uso y dificultades en el uso de cartas de remisión/respuesta (R/RL) e informes de alta hospitalaria (HDR). Para analizar las diferencias entre redes y años se utilizaron análisis descriptivos bivariados y modelos de regresión de Poisson con varianza robusta. Los resultados para ambas redes y años revelaron un mayor conocimiento y uso de los mecanismos de coordinación de la información que los relativos a la coordinación de la gestión clínica (aunque su conocimiento aumentó en 2017). Aunque ampliamente conocidos y utilizados, los importantes problemas relativos a la recepción infrecuente y tardía de los RL y HDR en AP, así como la mala calidad de sus contenidos, limitan su uso efectivo, lo que puede afectar a la calidad asistencial. Se requieren estrategias para mejorar el uso de los MCP.

Título traducido de la contribución	Cambios en el conocimiento y uso de los mecanismos de coordinación clínica entre niveles asistenciales en las redes de salud de Colombia
Idioma original	Inglés estadounidense
Páginas (desde-hasta)	134-150
Número de páginas	16
Publicación	International Journal of Health Planning and Management
Volumen	36
N.º	1
Fecha en línea anticipada	sept 29 2020
DOI	https://doi.org/10.1002/hpm.3073
Estado	Publicada - ene 1 2021

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

ODS 3: Salud y bienestar

Áreas temáticas de ASJC Scopus

Políticas sanitarias

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10.1002/hpm.3073

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title = "Changes in knowledge and use of clinical coordination mechanisms between care levels in healthcare networks of Colombia",

abstract = "Clinical coordination mechanisms (CCMs) have become key tools in healthcare networks for improving coordination between primary care (PC) and secondary care (SC) and are particularly relevant in health systems with highly fragmented healthcare provision. However, their implementation has been little studied to date in Latin America and particularly in Colombia. This study analyses the level of knowledge and use of CCMs between care levels and their changes between 2015 and 2017 in two public healthcare networks in Bogot{\'a}, Colombia. Comparison of two cross-sectional studies based on surveys among PC and SC doctors working in their networks (174 doctors per network/year). The COORDENA questionnaire was used for measuring knowledge concerning CCMs and the frequency of use and difficulties involved in using referral/reply letters (R/RLs) and hospital discharge reports (HDRs). Descriptive bivariate analysis and Poisson regression models with robust variance were used for analysing differences between networks and years. The results for both networks and years revealed greater knowledge and use of information coordination mechanisms than those regarding clinical management coordination (though their knowledge increased in 2017). Although widely known and used, significant problems regarding infrequent and late receipt of RLs and HDRs in PC as well as the poor quality of their contents limits their effective use, which may affect the quality of care. Strategies are required to improve CCMs use.",

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Changes in knowledge and use of clinical coordination mechanisms between care levels in healthcare networks of Colombia. / León-Arce, Heisel Gloria ; Mogollón-Pérez, Amparo Susana; Vargas, Ingrid et al.
En: International Journal of Health Planning and Management, Vol. 36, N.º 1, 01.01.2021, p. 134-150.

Producción científica: Contribución a revista › Artículo de Investigación › revisión exhaustiva

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AB - Clinical coordination mechanisms (CCMs) have become key tools in healthcare networks for improving coordination between primary care (PC) and secondary care (SC) and are particularly relevant in health systems with highly fragmented healthcare provision. However, their implementation has been little studied to date in Latin America and particularly in Colombia. This study analyses the level of knowledge and use of CCMs between care levels and their changes between 2015 and 2017 in two public healthcare networks in Bogotá, Colombia. Comparison of two cross-sectional studies based on surveys among PC and SC doctors working in their networks (174 doctors per network/year). The COORDENA questionnaire was used for measuring knowledge concerning CCMs and the frequency of use and difficulties involved in using referral/reply letters (R/RLs) and hospital discharge reports (HDRs). Descriptive bivariate analysis and Poisson regression models with robust variance were used for analysing differences between networks and years. The results for both networks and years revealed greater knowledge and use of information coordination mechanisms than those regarding clinical management coordination (though their knowledge increased in 2017). Although widely known and used, significant problems regarding infrequent and late receipt of RLs and HDRs in PC as well as the poor quality of their contents limits their effective use, which may affect the quality of care. Strategies are required to improve CCMs use.

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Changes in knowledge and use of clinical coordination mechanisms between care levels in healthcare networks of Colombia

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