Ítem
Acceso Abierto
Understanding communication breakdown in the outpatient referral process in Latin America : A cross-sectional study on the use of clinical correspondence in public healthcare networks of six countries
Título de la revista
Autores
Vargas, Ingrid
Garcia-Subirats, Irene
Mogollón Pérez, Amparo Susana
Ferreira-de-Medeiros-Mendes, Marina
Eguiguren, Pamela
Cisneros, Angelica-Ivonne
Muruaga, María-Cecilia
Bertolotto, Fernando
Vázquez, María-Luisa
Archivos
Fecha
2018
Directores
ISSN de la revista
Título del volumen
Editor
Buscar en:
Métricas alternativas
Resumen
Abstract
An adequate use of referral and reply letters - the main form of communication between primary care (PC) and out-patient secondary care (SC) - helps to avoid medical errors, test duplications and delays in diagnosis. However, it has been little studied to date in Latin America. The aim is to determine the level and characteristics of PC and SC doctors' use of referral and reply letters and to explore influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was conducted through a survey of PC and SC doctors working in public healthcare networks (348 doctors per country). The COORDENA questionnaire was applied to measure the frequency of use and receipt of referral and reply letters, quality of contents, timeliness and difficulties in using them. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between frequent use and associated factors. The great majority of doctors claim that they send referral letters to the other level. However, only half of SC doctors (a higher proportion in Chile and Mexico) report that they receive referral letters and <20% of PC doctors receive a reply from specialists. Insufficient recording of data is reported in terms of medical history, tests and medication and the reason for referral. The factor associated with frequent use of the referral letter is doctors' age, while the use of reply letters is associated with identifying PC doctors as care coordinators, knowing them and trusting in their clinical skills, and receiving referral letters. Significant problems are revealed in the use of referral and reply letters which may affect quality of care. Multifaceted strategies are required that foster a direct contact between doctors and a better understanding of the PC-based model. © 2018 The Author(s). Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved.
Palabras clave
Argentina , Brazil , Chile , Colombia , Cross-Sectional Study , General Practitioner , Human , Male , Mexico , Outpatient , Patient Referral , Questionnaire , Secondary Health Care , Skill , Uruguay , Writing , Cross-Sectional Study , Interpersonal Communication , Outpatient , Physician , Primary Health Care , Procedures , Public Relations , South And Central America , Communication , Correspondence As Topic , Cross-Sectional Studies , Interprofessional Relations , Latin America , Male , Outpatients , Physicians , Referral And Consultation , Secondary Care , Surveys And Questionnaires , Atención primaria de salud , Investigación de servicios de salud , Análisis multivariante
Keywords
Health services research , Medical history , Article , Female , Middle Aged , Adult , Female , Humans , Middle Aged
