Care coordination in two of Bogota’s public healthcare networks: A cross-sectional study among doctors

Abstract

Introduction Care coordination is a priority concern for healthcare systems. In Colombia, there is a lack of information on the topic. This study analysed how doctors of two Bogotá’s public healthcare networks perceived coordination between healthcare levels and what factors are associated with their perception. Methods A cross-sectional study using the COORDENA-CO questionnaire to a sample of 363 doctors (network-1 = 181; network-2 = 182) in 2015. The questionnaire asks about types and dimensions of care coordination: information and clinical management, with items in a Likert scale, as well as conditions regarding health system, organisational and doctors’ conditions. Descriptive statistics and logistic regression analysis were performed. Results The doctors’ perception of a high level of coordination did not exceed 25.4%. On coordination of information, limited transfer of clinical information was found. Concerning clinical management, there were limited care coherence, deficits in patient follow-up and lengthy waiting times for specialised care. A high perception of coordination were associated with being female, being over 50 years old, being a specialist, having less than one year’s working experience, working less than 20 h per week at the centre, forming part of network-1, having time available for performing coordination tasks, having job satisfaction and not identifying limitations imposed by healthcare insurers. Discussion There was limited perception of coordination, in its different dimensions and types with some differences between networks. The results support the importance of guaranteeing job satisfaction, ensuring sufficient time to coordination-related activities and intervening in the restrictions imposed by healthcare insurers to improve care coordination.

Changes in knowledge and use of clinical coordination mechanisms between care levels in healthcare networks of Colombia

“…[16][17][18] It could also be related to SC doctors not having sufficient time being available (indicated as a difficulty regarding R/RLs use) and/or low specialist interest in exchanging information with PC. These problems coincided with other studies' findings 3,16,29,32,33 This could also be related to organisational barriers. Among the most frequent reason for not receiving the R/RLs, were that referral letters were used for administrative purposes (i.e., for authorising specialist services); and that both R/RLs were often not handed in or became lost by patients (the main route for R/RLs reaching the other care level).…”

Towards seamless health care: no theory, no glory

“…7 Given the lack of information on care coordination in Colombia, Gallego-Ardila et al studied how doctors of two healthcare networks perceived coordination of information and clinical management. 8 This study shows that rather low levels of coordination were perceived, whereas the factors associated with the perception of coordination offers possibilities to change this rather alarming situation for the better. 8 More relevant studies from Colombia in this field are needed and hence the International Journal of Care Coordination explicitly invites researchers and evaluators from Colombia and other countries where care coordination is in its initial phase to submit their work.…”

Implementing joint training sessions of general practitioners and specialists aimed at improving clinical coordination in Colombia: Contributions from participatory action research

“…Clinical coordination between health care levels is essential for ensuring quality care and efficient resource use, 1 but it is not widely achieved in fragmented Latin American health care systems, including that of Colombia. [2][3][4] This study followed Longest and Young's definition of clinical coordination as 'the harmonious connection of the services needed to provide health care for a patient throughout the care continuum to achieve a common objective without conflicts'. 5 Cross-level clinical coordination mechanisms (CCM) 6 include programming-based CCM, such as standardising skills (e.g.…”