Factores que influyen en el uso de mecanismos de coordinación entre niveles asistenciales en Colombia
Bibliographic Data
| ID | 21482892 |
|---|---|
| Authors | Heisel Gloria León-Arce, Heisel Gloria León‐Arce (0000-0003-0731-7599, Universitat Autonòma de Barcelona), Amparo-Susana Mogollón-Pérez (0000-0003-3162-9664, Universidad del Rosario, corresponding author), Ingrid Vargas Lorenzo (Servei de Salut de les Illes Balears), María-Luisa Vázquez Navarrete (Servei de Salut de les Illes Balears) |
| Year | 2021 |
| Volume | 35 |
| Issue | 2 |
| Pages | 177-185 |
| Publication date | 2021-03-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Gaceta Sanitaria (JOURNAL) |
| Journal identifiers | ISSN: 0213-9111 • E-ISSN: 1578-1283 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.gaceta.2019.06.005 |
| PMID | 31630926 |
| OpenAlex | W2980396831 |
| Language | ES |
| Citations received | 7 |
| References cited | 23 |
Analizar los factores que inciden en la utilización de mecanismos de coordinación clínica entre niveles de atención en dos redes de servicios de salud de Bogotá (Colombia), desde la perspectiva de los actores principales. Estudio cualitativo, descriptivo-interpretativo, en dos redes de servicios de salud públicas, mediante entrevistas individuales semiestructuradas y grupos de discusión. Se realizó un muestreo teórico en dos etapas: 1) selección de centros de diferentes niveles de atención y 2) selección de informantes: directivos/as (n = 19), profesionales de salud (n = 23) y administrativos/as (n = 20). Se realizó un análisis de contenido, con generación mixta de categorías y segmentación por red, grupos de informantes y temas. En ambas redes se identificaron pocos mecanismos de coordinación clínica entre niveles, con predominio de los mecanismos de transferencia de información, y como mecanismos de coordinación de gestión clínica solo los dedicados a atención maternal-perinatal. Emergieron problemas uso relacionados con factores organizativos (falta de tiempo, rotación del personal, uso administrativo, déficit tecnológico) y de los/las profesionales (desinterés), con consecuencias sobre la coordinación (limitada transferencia de información y seguimiento de la atención) y la calidad de la atención (retrasos en diagnósticos y tratamientos). Los resultados indican una limitada implementación de mecanismos de coordinación clínica en general, con problemas en su uso. Se requieren cambios sobre factores organizativos (tiempo para la coordinación y condiciones de trabajo) y de los/las profesionales (actitudes hacia el trabajo colaborativo). To analyse the factors influencing the use of mechanisms for the clinical coordination of two Colombian public healthcare networks’ healthcare levels in Bogotá from the main social actors’ perspective. This was a descriptive-interpretative, qualitative study of two public healthcare networks. Discussion groups and semi-structured interviews were used for collecting information. The approach involved two-stage theoretical sampling of a selection of centres operating at different healthcare levels and a selection of informants, including managers (n = 19), healthcare employees (n = 23) and administrative staff (n = 20). Content analysis involved adopting a mixed method approach for generating categories, segmented by network, informant group and topic. Both networks had few mechanisms for enabling the clinical coordination of healthcare levels; information transfer mechanisms predominated and clinical management coordination mechanisms only dealt with maternal-perinatal care. Organisational factor-related complications were found regarding their use: lack of time, staff turnover, administrative use and technological deficiency. Employee/staff-related difficulties were due to lack of interest. These factors directly affected coordination with limited information transfer, patient follow-up and healthcare quality (diagnosis and treatment delays). The results highlighted the limited use of clinical coordination mechanisms in both public healthcare networks studied here, with problems in their use. Changes are required that affect directly organisational factors (time for coordination and working conditions) and professional factors (attitudes towards collaborative work)
Art · Humanities · Political science · Health and Medical Education · Healthcare Systems and Technology · Stress and Burnout Research
Understanding How to Improve the Use of Clinical Coordination Mechanisms between Primary and Secondary Care Doctors
Experiencia de mujeres con infección prenatal por virus Zika que continuaron la gestación en Colombia
Relational Continuity of Chronic Patients with Primary and Secondary Care Doctors
Planificação da atenção à saúde
Assessing the impact of clinical coordination interventions on the continuity of care for patients with chronic conditions
Barreras y factores asociados al uso de mecanismos de coordinación entre niveles de atención en México
Coordenação da gestão clínica entre níveis
Health fee exemptions
Understanding communication breakdown in the outpatient referral process in Latin America
Barriers to healthcare coordination in market-based and decentralized public health systems
La renovación de la atención primaria de salud en las Américas
Qualitative Data Analysis
Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries
| Citations per year | 1.4 |
|---|---|
| Citation span | 2021 - 2023 (3) |
| Highly cited | No |