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

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

14 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

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

ODS 11: Ciudades y comunidades sostenibles

Áreas temáticas de ASJC Scopus

Evaluación y diagnóstico

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10.1016/j.gaceta.2018.09.009

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https://www.scopus.com/pages/publications/85058544111

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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\}",

note = "Publisher Copyright: {\textcopyright} 2018 SESPAS",

year = "2020",

month = jul,

day = "1",

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

language = "English (US)",

volume = "34",

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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 - https://www.scopus.com/pages/publications/85058544111

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

Resumen

ODS de las Naciones Unidas

Áreas temáticas de ASJC Scopus

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