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

doi:10.1016/j.gaceta.2018.09.009

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

Título traducido de la contribución: Conocimiento y uso de mecanismos de coordinación clínica en redes 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

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13 Citas (Scopus)

Resumen

2018 SESPAS Objetivo: Analizar el nivel de conocimiento y uso, y las características de uso, de los mecanismos de coordinación asistencial en las redes públicas de salud de seis países de América Latina. Método: Estudio transversal basado en una encuesta con el cuestionario COORDENA® a médicos de atención primaria y secundaria (348 médicos/país) de redes sanitarias públicas de Argentina, Brasil, Chile, Colombia, México y Uruguay (mayo-octubre 2015). Variables analizadas: grado de conocimiento y uso de mecanismos de coordinación de la información (carta de derivación/respuesta, informe de alta, teléfono, correo electrónico) y de coordinación de la gestión clínica (guías clínicas compartidas, reuniones conjuntas). Se realizaron análisis descriptivos. Resultados: El conocimiento de los mecanismos de coordinación de la información clínica fue elevado en ambos niveles asistenciales y redes analizadas, así como el uso de la carta de derivación/respuesta. Hubo mayor variabilidad en el uso de informes de alta (de 40,0% en Brasil a 79,4% en México) y, salvo en Argentina, destaca la baja recepción reportada por los médicos de atención primaria (12,3% en Colombia y 55,1% en Uruguay). Por el contrario, el conocimiento de los mecanismos de coordinación de la gestión clínica fue limitado, especialmente entre los médicos de atención secundaria. Cabe destacar, sin embargo, que la adherencia a guías clínicas fue alta (de 83,1% en México a 96,8% en Brasil), mientras que la participación en reuniones conjuntas varió ampliamente (de 23,7% en Chile a 76,2% en Brasil). Las dificultades señaladas en el uso de los mecanismos están relacionadas con factores estructurales y organizativos. Conclusiones: El escaso conocimiento y uso de los mecanismos de coordinación muestra una insuficiente difusión e implementación. Se necesitan estrategias para aumentar su uso, incluyendo los factores relacionados.

Título traducido de la contribución	Conocimiento y uso de mecanismos de coordinación clínica en redes de servicios de salud de Latinoamérica
Idioma original	Inglés estadounidense
Páginas (desde-hasta)	340-349
Número de páginas	9
Publicación	Gaceta Sanitaria
Volumen	34
N.º	4
DOI	https://doi.org/10.1016/j.gaceta.2018.09.009
Estado	Publicada - jul. 1 2020

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Evaluación y diagnóstico

ODS de las Naciones Unidas

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@article{f34aaf6d98c648ee84c90aafda059aae,

title = "Conocimiento y uso de mecanismos de coordinaci{\'o}n cl{\'i}nica de servicios de salud de Latinoam{\'e}rica",

abstract = "{\textcopyright} 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{\textregistered} 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.",

author = "{Miranda Mendizabal}, {Andrea Estefania} and {Vargas Lorenzo}, Ingrid and {Mogollon Perez}, {Amparo Susana} and {Ferreira de Madeiros}, Marina and Isabela Samico and Pamela Eguiguren and Julieta L{\'o}pez and Fernando Bertolotto and Delia Amarilla and V{\'a}zquez, {Mar{\'i}a Luisa}",

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year = "2020",

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day = "1",

doi = "10.1016/j.gaceta.2018.09.009",

language = "English (US)",

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Conocimiento y uso de mecanismos de coordinación clínica de servicios de salud de Latinoamérica. / Miranda Mendizabal, Andrea Estefania; Vargas Lorenzo, Ingrid ; Mogollon Perez, Amparo Susana et al.
En: Gaceta Sanitaria, Vol. 34, N.º 4, 01.07.2020, p. 340-349.

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

TY - JOUR

T1 - Conocimiento y uso de mecanismos de coordinación clínica de servicios de salud de Latinoamérica

AU - Miranda Mendizabal, Andrea Estefania

AU - Vargas Lorenzo, Ingrid

AU - Mogollon Perez, Amparo Susana

AU - Ferreira de Madeiros, Marina

AU - Samico, Isabela

AU - Eguiguren, Pamela

AU - López, Julieta

AU - Bertolotto, Fernando

AU - Amarilla, Delia

AU - Vázquez, María Luisa

PY - 2020/7/1

Y1 - 2020/7/1

N2 - © 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.

AB - © 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.

UR - http://www.scopus.com/inward/record.url?scp=85058544111&partnerID=8YFLogxK

U2 - 10.1016/j.gaceta.2018.09.009

DO - 10.1016/j.gaceta.2018.09.009

M3 - Research Article

C2 - 30578041

AN - SCOPUS:85058544111

SN - 0213-9111

VL - 34

SP - 340

EP - 349

JO - Gaceta Sanitaria

JF - Gaceta Sanitaria

IS - 4

ER -

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

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