Integración entre cardiología y atención primaria: impacto sobre la práctica clínica

Falces, Carlos; Andrea, Rut; Heras, Magda; Vehí, Cristina; Sorribes, Marta; Sanchís, Laura; Cevallos, Joaquim; Menacho, Ignacio; Porcar, Sílvia; Font, David García; Sabaté, Manel; Brugada, Josep

doi:10.1016/j.recesp.2011.02.021

Cited by 60 publications

(17 citation statements)

References 27 publications

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“…Additionally, process-related outcomes included improved documentation of outcomes by the GP ( 19) and an improved disease-speci c medication dispensing (41). Finally, some interventions were reported to increase costs slightly (20) or to not increase resources (48).…”

Section: Outcomes and Results Of Projectsmentioning

confidence: 99%

“…Of the 22 original projects, ve were located in the United States (19, 23, 24, 31-33, 35-37, 45, 46), four in Canada (21, 22, 29, 30, 42); two projects, respectively, were located in Australia (43, 44, 47), Brazil (41), Spain (28,48), Switzerland (26,27,38) and the Netherlands (20,49). One project was based in Germany (25), Italy (34) and New Zealand (39).…”

Section: Origin and Study Designmentioning

confidence: 99%

“…Care arrangements between GPs and specialists were usually based on knowledge transfer and hands-on teaching without planning formal education events (19,23,24,28,29,49). As an example, Falces et al, integrated a cardiologist into a primary care practice to support follow-up (48). Similarly, the project of Hynes and Porter introduced new HCPs in the patient-centered medical home, who shared their information in multidisciplinary team meetings (31)(32)(33)38).…”

Section: Education and Knowledge Transfermentioning

confidence: 99%

“…The physicians were able to establish their own referral criteria and actively discuss their different responsibilities. In this case, specialists provided medical advice when needed, and had weekly consultation sessions with GPs (48). Even though the specialist took the lead in joint consultations with the GP and patients in a Spanish study, the GP was still the main person of contact for the patient (28).…”

Section: Role Distributionsmentioning

confidence: 99%

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Challenging collaboration of general practitioners and specialists for patients with complex chronic conditions: A scoping review to identify improvement strategies

Tomaschek

Lampart

Scheel‐Sailer

et al. 2021

Preprint

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BackgroundCollaboration between medical specialists and general practitioners (GPs) is well known from daily practice, but research on the topic is rather scarce. This scoping review summarizes role distributions and components of this collaboration that have potential for improvement for the care of patients with complex chronic conditions. Methods Scoping review as a knowledge synthesis for components of collaboration and role distributions between medical specialists and GPs in intervention studies. The PubMed database was searched for literature from 2010-2020.ResultsLiterature search and reference screening generated 2,174 articles. Of these, 30 articles originating from 22 unique projects were included in our synthesis. These projects focus on different patient populations and take diverse approaches to improve collaboration within an intervention. The GP is most commonly in charge of patient management and extends the scope of practice. The specialist provides support when needed. Clear definition of roles and responsibilities, resources for knowledge exchange and raising awareness through education from specialists for specific health conditions are commonly utilized interventions. Typically, combinations of process and system changes that address communication and coordination issues are applied. Most interventions improve provider and patient satisfaction, health outcomes, and reduce fragmentation of patient care.ConclusionInterventions to improve collaboration between GPs and medical specialists seem promising. Further efforts should be made to test and apply the findings in broad clinical practice.

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Section: Outcomes and Results Of Projectsmentioning

confidence: 99%

Section: Origin and Study Designmentioning

confidence: 99%

Section: Education and Knowledge Transfermentioning

confidence: 99%

Section: Role Distributionsmentioning

confidence: 99%

See 2 more Smart Citations

Challenging collaboration of general practitioners and specialists for patients with complex chronic conditions: A scoping review to identify improvement strategies

Tomaschek

Lampart

Scheel‐Sailer

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…[ 3 ] Integrated cardiology and primary care services can improve follow up and chronic treatment of patients with ischemic heart disease, heart failure, and atrial fibrillation while increasing primary care provider satisfaction and stabilizing resource utilization. [ 4 ] Novel care systems incorporating an observation unit and a short term outpatient follow up clinic have been deployed, significantly reducing hospital admission rates regardless of comorbidities. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation care improvement collaborative

Robelia

Kopecky

Thacher

2015

BMJ Qual Improv Report

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Atrial fibrillation (AF) is an increasingly common cardiac arrhythmia. Many patients with new onset or recurrent AF present to the emergency department and are subsequently admitted to the hospital and seen by cardiology specialists for follow up. In an attempt to address this high utilization of acute health care resources, reduce costs, and improve patient care, our institution instituted a collaborative project between the departments of emergency medicine, cardiology, family medicine, and primary care internal medicine.The project team oversaw development of a new emergency department AF order set, encouraged utilization of a new oral anticoagulant (dabigatran), improved the primary care follow up connection, and deployed a multimodal education plan for primary care providers. Between 2012 and 2014, these interventions resulted in a 17% reduction in total AF per member per month (PMPM) cost, a 28% reduction in AF PMPM inpatient cost, and a 24% reduction in inpatient admissions for AF.

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Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?

Amado

Marques

Nunes

2022

Health Planning & Management

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Introduction: Vertical integration models involve integrating services from different levels of care (e.g., primary care, acute care, post-acute care). Therefore, one of their main objectives is to increase continuity of care, potentially improving outcomes like efficiency, quality, and access or even enabling cost containment.Objectives: This study conducts a literature review and aims at contributing to the contentious discussion regarding the effects of vertical integration reforms in terms of efficiency, costs containment, quality, and access.Methods: We performed a systematic search of the literature published until February 2020. The articles respecting the conceptual framework were included in an exhaustive analysis to study the impact of vertical integration on costs, prices of care, efficiency, quality, and access.Results: A sample of 64 papers resulted from the screening process. The impact of vertical integration on costs and prices of care appears to be negative. Decreases in technical efficiency upon vertical integration are practically out of the question. Nevertheless, there is no substantial inclination to visualise a positive influence. The same happens with the quality of care. Regarding access, the lack of available articles on this outcome limits conjectures.Conclusions: In summary, it is not clear yet whether vertically integrated healthcare providers positively impact the overall delivery care system. Nevertheless, the recent grow-

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Integración entre cardiología y atención primaria: impacto sobre la práctica clínica

Cited by 60 publications

References 27 publications

Challenging collaboration of general practitioners and specialists for patients with complex chronic conditions: A scoping review to identify improvement strategies

Challenging collaboration of general practitioners and specialists for patients with complex chronic conditions: A scoping review to identify improvement strategies

Atrial fibrillation care improvement collaborative

Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?

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