New Model of Integration Between Primary Health Care and Specialized Cardiology Care

Hernández-Afonso, Julio; Facenda-Lorenzo, María; Rodríguez-Esteban, Marcos; Hernandez-Garcia, Celestino; Núñez-Chicharro, Leonor; Viñas-Pérez, Antonia D.

doi:10.1016/j.rec.2017.02.004

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…Although there are previous experiences in other medical specialties, to the best of our knowledge, this is the frst time an e-consultation model is applied to pulmonology [22][23][24][25][26][27]. In total, 43.5% of cases were solved via e-consultation, slightly exceeding our estimates, and in an intermediate range with respect to previous studies (range: 21.4-69%) [6,22,23]. Te proportion of cases solved via e-consultation is expected to decrease over the years as a result of two efects: learning, as clinicians will progressively improve their patient management skills; and dissuasive, due to an increasing awareness that minor respiratory problems are rarely referred to a face-to-face consult.…”

Section: Discussionmentioning

confidence: 99%

“…The implementation of this model reduced significantly the mean waiting time. Although there are previous experiences in other medical specialties, to the best of our knowledge, this is the first time an e-consultation model is applied to pulmonology [ 22 – 27 ]. In total, 43.5% of cases were solved via e-consultation, slightly exceeding our estimates, and in an intermediate range with respect to previous studies (range: 21.4–69%) [ 6 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Álvarez-Dobaño

Toubes

Novo-Platas³

et al. 2022

Canadian Respiratory Journal

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Introduction. This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit. Materials and Methods. A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists. Results. In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 ( p < 0.001 ). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062. Conclusions. Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Álvarez-Dobaño

Toubes

Novo-Platas³

et al. 2022

Canadian Respiratory Journal

View full text Add to dashboard Cite

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“…This insufficient coordination between primary care and other specialties leads to a heterogeneity in the management of patients with chronic conditions, unsuccessful achievement of therapeutic goals, duplication of complementary tests, unnecessary visits to the specialist, dissatisfaction of patients with medical attention, and importantly, to more adverse outcomes [10,11]. Although different initiatives to improve healthcare integration have been developed, it remains unknown which continuity of care model may improve this integration to a greater extent [12][13][14][15][16].…”

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confidence: 99%

Impact of Different Models of Improvement of Continuity of Care On Lipid Control and the Delay of Visits to Cardiology

et al. 2019

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Aims: To analyze the impact of implementing three different models of continuity of care on the delay of first visits to the cardiologist (management end point) and on LDL-cholesterol control rates among patients with atherosclerotic vascular disease (clinical end point). Methods: Observational, longitudinal and retrospective study of patients with cardiovascular disease and LDL-cholesterol ≥70 mg/dl attended in three hospitals (H1/H2/H3). In H1 and H2, a virtual system (telecardiology) was developed (in H1, internal audits and specific medical education were also performed). In H3 a cardiologist was integrated into the primary care center. Results: The delay of visits to cardiologist significantly improved from 66.5 ± 29.1 days to 34.1 ± 14.1 days (p < 0.001), as well as the intensification of lipid-lowering treatment and the achievement of lipid goals. LDL-cholesterol control rates were higher in H1 and the reduction of the delay of visits in H3. Conclusion: Continuity of care is associated with improvements in management and clinical end points.

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New Model of Integration Between Primary Health Care and Specialized Cardiology Care

Cited by 2 publications

References 5 publications

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Impact of Different Models of Improvement of Continuity of Care On Lipid Control and the Delay of Visits to Cardiology

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