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

Datos Bibliográficos

ID4601413
AutoresMaría-Luisa Vázquez (0000-0002-6091-8193, Consortium for Health and Social Catalonia, autor de correspondencia), Íngrid Vargas (0000-0002-1778-2411, Consortium for Health and Social Catalonia), Irene Garcia-Subirats (Consortium for Health and Social Catalonia), Jean-Pierre Unger (0000-0001-5152-6545, Instituut voor Tropische Geneeskunde), Pierre De Paepe (Instituut voor Tropische Geneeskunde), Amparo-Susana Mogollón-Pérez (0000-0003-3162-9664, Universidad del Rosario), Amparo Susana Mogollón-Pérez, Isabella Samico, Isabella Chagas Samico (0000-0002-8338-7946, Instituto de Medicina Integral Professor Fernando Figueira), Pamela Eguiguren (0000-0002-0198-4123, University of Chile), Angelica-Ivonne Cisneros (Universidad Veracruzana), Adriana Huerta, María-Cecilia Muruaga (National University of Rosario), Fernando Bertolotto (0000-0001-9963-3630, Universidad de la República de Uruguay)
Año2017
Volumen182
Páginas10-19
Fecha de publicación2017-06-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSocial Science & Medicine (JOURNAL)
Identificadores de la revistaISSN: 0277-9536 • E-ISSN: 1873-5347
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2017.04.001
PMID28411523
OpenAlexW2602722382
IdiomaEN
Citas recibidas20
Referencias citadas22

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

Cross-sectional study · Economic growth · Family medicine · Health care · Latin Americans · Logistic regression · Multivariate analysis · Perception · Political science · Public health · Salary · Healthcare Policy and Management · Healthcare Systems and Technology · Medicine · Nursing · Primary Care and Health Outcomes · Psychology