Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system
Abstract Objective To analyse doctors’ opinions on clinical coordination between primary and secondary care in different healthcare networks and on the factors influencing it. Methods A qualitative descriptive-interpretative study was conducted, based on semi-structured interviews. A two-stage theoretical sample was designed: 1) healthcare networks with different management models; 2) primary care and secondary care doctors in each network. Final sample size (n = 50) was reached by saturation. A thematic content analysis was conducted. Results In all networks doctors perceived that primary and secondary care given to patients was coordinated in terms of information transfer, consistency and accessibility to SC following a referral. However, some problems emerged, related to difficulties in acceding non-urgent secondary care changes in prescriptions and the inadequacy of some referrals across care levels. Doctors identified the following factors: 1) organizational influencing factors: coordination is facilitated by mechanisms that facilitate information transfer, communication, rapid access and physical proximity that fosters positive attitudes towards collaboration; coordination is hindered by the insufficient time to use mechanisms, unshared incentives in prescription and, in two networks, the change in the organizational model; 2) professional factors: clinical skills and attitudes towards coordination. Conclusions Although doctors perceive that primary and secondary care is coordinated, they also highlighted problems. Identified factors offer valuable insights on where to direct organizational efforts to improve coordination.
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Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)
2019
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oai:scielo:S0213-911120190001000122020-12-02Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare systemAller,Marta-BeatrizVargas,IngridCoderch,JordiCalero,SebastiàCots,FrancescAbizanda,MercèColomés,LluísFarré,JoanVázquez-Navarrete,María-Luisa Clinical coordination between care levels Integrated health care Interprofessional relations Organizational models Qualitative research Abstract Objective To analyse doctors’ opinions on clinical coordination between primary and secondary care in different healthcare networks and on the factors influencing it. Methods A qualitative descriptive-interpretative study was conducted, based on semi-structured interviews. A two-stage theoretical sample was designed: 1) healthcare networks with different management models; 2) primary care and secondary care doctors in each network. Final sample size (n = 50) was reached by saturation. A thematic content analysis was conducted. Results In all networks doctors perceived that primary and secondary care given to patients was coordinated in terms of information transfer, consistency and accessibility to SC following a referral. However, some problems emerged, related to difficulties in acceding non-urgent secondary care changes in prescriptions and the inadequacy of some referrals across care levels. Doctors identified the following factors: 1) organizational influencing factors: coordination is facilitated by mechanisms that facilitate information transfer, communication, rapid access and physical proximity that fosters positive attitudes towards collaboration; coordination is hindered by the insufficient time to use mechanisms, unshared incentives in prescription and, in two networks, the change in the organizational model; 2) professional factors: clinical skills and attitudes towards coordination. Conclusions Although doctors perceive that primary and secondary care is coordinated, they also highlighted problems. Identified factors offer valuable insights on where to direct organizational efforts to improve coordination.Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)Gaceta Sanitaria v.33 n.1 20192019-02-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-91112019000100012en |
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Aller,Marta-Beatriz Vargas,Ingrid Coderch,Jordi Calero,Sebastià Cots,Francesc Abizanda,Mercè Colomés,Lluís Farré,Joan Vázquez-Navarrete,María-Luisa |
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Aller,Marta-Beatriz Vargas,Ingrid Coderch,Jordi Calero,Sebastià Cots,Francesc Abizanda,Mercè Colomés,Lluís Farré,Joan Vázquez-Navarrete,María-Luisa Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system |
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Aller,Marta-Beatriz Vargas,Ingrid Coderch,Jordi Calero,Sebastià Cots,Francesc Abizanda,Mercè Colomés,Lluís Farré,Joan Vázquez-Navarrete,María-Luisa |
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Aller,Marta-Beatriz |
title |
Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system |
title_short |
Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system |
title_full |
Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system |
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Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system |
title_full_unstemmed |
Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system |
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doctors' opinions on clinical coordination between primary and secondary care in the catalan healthcare system |
description |
Abstract Objective To analyse doctors’ opinions on clinical coordination between primary and secondary care in different healthcare networks and on the factors influencing it. Methods A qualitative descriptive-interpretative study was conducted, based on semi-structured interviews. A two-stage theoretical sample was designed: 1) healthcare networks with different management models; 2) primary care and secondary care doctors in each network. Final sample size (n = 50) was reached by saturation. A thematic content analysis was conducted. Results In all networks doctors perceived that primary and secondary care given to patients was coordinated in terms of information transfer, consistency and accessibility to SC following a referral. However, some problems emerged, related to difficulties in acceding non-urgent secondary care changes in prescriptions and the inadequacy of some referrals across care levels. Doctors identified the following factors: 1) organizational influencing factors: coordination is facilitated by mechanisms that facilitate information transfer, communication, rapid access and physical proximity that fosters positive attitudes towards collaboration; coordination is hindered by the insufficient time to use mechanisms, unshared incentives in prescription and, in two networks, the change in the organizational model; 2) professional factors: clinical skills and attitudes towards coordination. Conclusions Although doctors perceive that primary and secondary care is coordinated, they also highlighted problems. Identified factors offer valuable insights on where to direct organizational efforts to improve coordination. |
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Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) |
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2019 |
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http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-91112019000100012 |
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