Understanding How to Improve the Use of Clinical Coordination Mechanisms between Primary and Secondary Care Doctors: Clues from Catalonia

International Journal of Environmental Research and Public Health

Joan-Manuel Pérez-Castejón¹  Pere Plaja²  Ingrid Vargas³  Franco Amigo³  María-Luisa Vázquez³  Laura Esteve-Matalí³  Francesc Cots⁴  ErickF. Mayer⁵ 

[1] Badalona Serveis Assistencials, 08911 Badalona, Spain;Fundació Salut Empordà, 17600 Figueres, Spain;Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, 08022 Barcelona, Spain;Parc de Salut Mar, 08019 Barcelona, Spain;Serveis de Salut Integrats Baix Empordà, 17230 Palamós, Spain;

关键词: clinical coordination;    coordination mechanisms;    primary care;    secondary care;    electronic medical record;    remote consultation;   

DOI  :  10.3390/ijerph18063224

来源: DOAJ

【 摘 要 】

Clinical coordination between primary (PC) and secondary care (SC) is a challenge for health systems, and clinical coordination mechanisms (CCM) play an important role in the interface between care levels. It is therefore essential to understand the elements that may hinder their use. This study aims to analyze the level of use of CCM, the difficulties and factors associated with their use, and suggestions for improving clinical coordination. A cross-sectional online survey-based study using the questionnaire COORDENA-CAT was conducted with 3308 PC and SC doctors in the Catalan national health system. Descriptive bivariate analysis and logistic regression models were used. Shared Electronic Medical Records were the most frequently used CCM, especially by PC doctors, and the one that presented most difficulties in use, mostly related to technical problems. Some factors positively associated with frequent use of various CCM were: working full-time in integrated areas, or with local hospitals. Interactional and organizational factors contributed to a greater extent among SC doctors. Suggestions for improving clinical coordination were similar between care levels and related mainly to the improvement of CCM. In an era where management tools are shifting towards technology-based CCM, this study can help to design strategies to improve their effectiveness.

【 授权许可】

Unknown