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dc.creatorVargas, Ingrid 
dc.creatorGarcia-Subirats, Irene 
dc.creatorMogollón-Pérez, Amparo-Susana 
dc.creatorFerreira-de-Medeiros-Mendes, Marina 
dc.creatorEguiguren, Pamela 
dc.creatorCisneros, Angelica-Ivonne 
dc.creatorMuruaga, María-Cecilia 
dc.creatorBertolotto, Fernando 
dc.creatorVázquez, María-Luisa 
dc.date.accessioned2019-09-26T17:16:03Z
dc.date.available2019-09-26T17:16:03Z
dc.date.created2018
dc.date.issued2018
dc.identifier.issn0268-1080
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/20346
dc.description.abstractAn 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.
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.relation.ispartofHealth Policy and Planning, ISSN:2681-080, Vol. 33 (2018) pp. 494-504
dc.relation.urihttps://academic.oup.com/heapol/article/33/4/494/4857369
dc.subjectArgentina
dc.subjectBrazil
dc.subjectChile
dc.subjectColombia
dc.subjectCross-Sectional Study
dc.subjectGeneral Practitioner
dc.subjectHuman
dc.subjectMale
dc.subjectMexico
dc.subjectOutpatient
dc.subjectPatient Referral
dc.subjectQuestionnaire
dc.subjectSecondary Health Care
dc.subjectSkill
dc.subjectUruguay
dc.subjectWriting
dc.subjectCross-Sectional Study
dc.subjectInterpersonal Communication
dc.subjectOutpatient
dc.subjectPhysician
dc.subjectPrimary Health Care
dc.subjectProcedures
dc.subjectPublic Relations
dc.subjectSouth And Central America
dc.subjectCommunication
dc.subjectCorrespondence As Topic
dc.subjectCross-Sectional Studies
dc.subjectInterprofessional Relations
dc.subjectLatin America
dc.subjectMale
dc.subjectOutpatients
dc.subjectPhysicians
dc.subjectReferral And Consultation
dc.subjectSecondary Care
dc.subjectSurveys And Questionnaires
dc.subjectAtención primaria de salud
dc.subjectInvestigación de servicios de salud
dc.subjectAnálisis multivariante
dc.subject.ddcAdministración general 
dc.subject.lembAdministración de servicios de salud
dc.subject.lembSalud pública
dc.subject.lembResponsabilidad médica
dc.titleUnderstanding 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
dc.typearticle
dc.subject.keywordAdult
dc.subject.keywordHealth services research
dc.subject.keywordMedical history
dc.subject.keywordArticle
dc.subject.keywordPrimary health care
dc.subject.keywordFemale
dc.subject.keywordMiddle Aged
dc.subject.keywordAdult
dc.subject.keywordFemale
dc.subject.keywordHumans
dc.subject.keywordMiddle Aged
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaArtículo
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.source.bibliographicCitationAlmeida, P.F., Giovanella, L., Mendonca, M.H., Escorel, S., Challenges for healthcare coordination: Strategies for integrating levels of care in large cities (2010) Cadernos de Saude Publica, 26, pp. 286-298
dc.creator.googleVargas, I., Garcia-Subirats, I., Mogollón-Pérez, A.-S., Ferreira-De-Medeiros-Mendes, M., Eguiguren, P., Cisneros, A.-I., Muruaga, M.-C., Bertolotto, F., Vázquez, M.-L.
dc.creator.googleVargas, Ingrid
dc.creator.googleGarcia-Subirats, Irene
dc.creator.googleMogollón-Pérez, Amparo-Susana
dc.creator.googleFerreira-de-Medeiros-Mendes, Marina
dc.creator.googleEguiguren, Pamela
dc.creator.googleCisneros, Angelica-Ivonne
dc.creator.googleMuruaga, María-Cecilia
dc.creator.googleBertolotto, Fernando
dc.creator.googleVázquez, María-Luisa
dc.identifier.doi10.1093/heapol/czy016
dc.relation.citationEndPage504
dc.relation.citationStartPage494
dc.relation.citationTitleHealth Policy and Planning
dc.relation.citationVolumeVol. 33


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