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

María Luisa Vázquez, Ingrid Vargas, Irene Garcia-Subirats, Jean Pierre Unger, Pierre De Paepe, Amparo Susana Mogollón-Pérez, Isabella Samico, Pamela Eguiguren, Angelica Ivonne Cisneros, Adriana Huerta, María Cecilia Muruaga, Fernando Bertolotto

Resultado de la investigación: Contribución a RevistaArtículo

3 Citas (Scopus)

Resumen

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.

Idioma originalEnglish (US)
Páginas (desde-hasta)10-19
Número de páginas10
PublicaciónSocial Science and Medicine
Volumen182
DOI
EstadoPublished - jun 1 2017

Huella dactilar

Secondary Care
cross-sectional study
Primary Health Care
Cross-Sectional Studies
Delivery of Health Care
experience
Referral and Consultation
Logistic Models
Uruguay
Information Management
Clinical Competence
Colombia
Job Satisfaction
Chile
Salaries and Fringe Benefits
Argentina
Mexico
Brazil
Healthcare
Doctors

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • History and Philosophy of Science

Citar esto

Vázquez, María Luisa ; Vargas, Ingrid ; Garcia-Subirats, Irene ; Unger, Jean Pierre ; De Paepe, Pierre ; Mogollón-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. En: Social Science and Medicine. 2017 ; Vol. 182. pp. 10-19.
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abstract = "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.",
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Vázquez, ML, Vargas, I, Garcia-Subirats, I, Unger, JP, De Paepe, P, Mogollón-Pérez, AS, Samico, I, Eguiguren, P, Cisneros, AI, Huerta, A, Muruaga, MC & Bertolotto, F 2017, 'Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries', Social Science and Medicine, vol. 182, pp. 10-19. https://doi.org/10.1016/j.socscimed.2017.04.001

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; Mogollón-Pérez, Amparo Susana; Samico, Isabella; Eguiguren, Pamela; Cisneros, Angelica Ivonne; Huerta, Adriana; Muruaga, María Cecilia; Bertolotto, Fernando.

En: Social Science and Medicine, Vol. 182, 01.06.2017, p. 10-19.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries

AU - Vázquez, María Luisa

AU - Vargas, Ingrid

AU - Garcia-Subirats, Irene

AU - Unger, Jean Pierre

AU - De Paepe, Pierre

AU - Mogollón-Pérez, Amparo Susana

AU - Samico, Isabella

AU - Eguiguren, Pamela

AU - Cisneros, Angelica Ivonne

AU - Huerta, Adriana

AU - Muruaga, María Cecilia

AU - Bertolotto, Fernando

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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.

AB - 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.

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