How do primary and secondary care physicians experience clinical coordination in health service networks in Mexico? Comparative analysis 2015-2017
Authors
Julieta López-Vázquez
Universidad Veracruzana. Instituto de Salud Pública
Néstor Cabrera-Mendoza
Universidad Veracruzana. Instituto de Salud Pública
Ingrid Vargas
Consorci de Salut i Social de Catalunya. Grup de Recerca en Polítiques de Salut i Serveis Sanitaris (GRPSS). Servei d’Estudis i Prospectives en Polítiques de Salut
María Luisa Vázquez
Consorci de Salut i Social de Catalunya. Grup de Recerca en Polítiques de Salut i Serveis Sanitaris (GRPSS). Servei d’Estudis i Prospectives en Polítiques de Salut
Introduction: Analyze the experience and perception of clinical coordination between levels of care´s primary and secondary care physicians and its changes between 2015- 2017 in two health service networks in Mexico.
Materials and Methods: Analysis of two cross-sectional studies through a survey to 728 doctors in health service networks in Xalapa and Veracruz.
Result variables: organizational and interaction factors; experience in information coordination; clinical management and general perception of coordination. Analysis of changes using Poisson regression.
Results: In 2015, physicians in both networks and levels reported little personal knowledge and confidence in the clinical skills of physicians at the other level of care, as well as limited coordination, mainly in exchange information, coherence of care, follow up and accessibility between levels. Perception of coordination was also low. In 2017, Xalapa significantly improved mutual knowing and trust, recognition of primary care as care coordinator, identificatio of managers as facilitators of coordination, exchange of clinical information, agreement with prescribed treatments, follow up in primary care and patient access to specialized care.
Discussion: Important problems of clinical coordination between levels are evident and a different evolution between the analyzed networks, it could be related to organizational changes aimed at reinforcing coordination between levels through participatory strategies based on mutual feedback.
Keywords:
Care coordination, Health services, Primary health care, Secondary health care, Health services administration
Author Biography
Julieta López-Vázquez, Universidad Veracruzana. Instituto de Salud Pública
Departamento de Pediatría, de Obstetricia y Ginecología, y de Medicina Preventiva, Universidad Autónoma de Barcelona, Bellaterra. (Cerdanyola del Vallés, Barcelona)
López-Vázquez, J., Cabrera-Mendoza, N. ., Vargas, I. ., & Vázquez, M. L. . (2023). How do primary and secondary care physicians experience clinical coordination in health service networks in Mexico? Comparative analysis 2015-2017. Revista Chilena De Salud Pública, 26(2), p. 124–139. https://doi.org/10.5354/0719-5281.2022.71176
