Knowledge and use of clinical coordination mechanisms in healthcare networks in Latin America

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. © 2018 SESPAS

• Fecha de publicación: 2018
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/24112
• Acceso en línea: https://doi.org/10.1016/j.gaceta.2018.09.009; https://repository.urosario.edu.co/handle/10336/24112
• Palabra clave: Argentina; Article; Brazil; Chile; Colombia; Coordination; Cross-sectional study; Diffusion; E-mail; General practitioner; Human; Human experiment; Joint; Mexico; Patient referral; Practice guideline; Primary health care; Questionnaire; Secondary health care; Uruguay; Clinical coordination; Clinical coordination mechanisms; Integrated health care; Latin America; Primary health care
• License: http://purl.org/coar/access_right/c_abf2