Has cross-level clinical coordination changed in the context of the pandemic? The case of the Catalan health system

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• dc.contributor.author Campaz Landazabal, Daniela
• dc.contributor.author Vargas Lorenzo, Ingrid
• dc.contributor.author Sánchez, Elvira
• dc.contributor.author Cots Reguant, Francesc
• dc.contributor.author Plaja, Pere
• dc.contributor.author Pérez Castejón, Joan Manuel
• dc.contributor.author Sánchez Hidalgo, Antonio
• dc.contributor.author Vázquez, María Luisa
• dc.date.accessioned 2025-03-06T07:23:32Z
• dc.date.available 2025-03-06T07:23:32Z
• dc.date.issued 2024
• dc.description.abstract Background: The COVID-19 pandemic triggered numerous changes in health services organisation, whose effects on clinical coordination are unknown. The aim is to analyse changes in the experience and perception of cross-level clinical coordination and related factors of primary (PC) and secondary care (SC) doctors in the Catalan health system between 2017 and 2022. Methods: Comparison of two cross-sectional studies based on online surveys by means of the self-administration of the COORDENA-CAT (2017) and COORDENA-TICs (2022) questionnaires to PC and SC doctors. Final sample n = 3308 in 2017 and n = 2277 in 2022. Outcome variables: experience of cross-level information and clinical management coordination and perception of cross-level clinical coordination in the healthcare area and related factors. Stratification variables: level of care and year. Adjusting variables: sex, years of experience, type of specialty, type of hospital, type of management of PC/SC. Descriptive bivariate and multivariate analysis using Poisson regressions models to detect changes between years in total and by levels of care. Results: Compared with 2017, while cross-level clinical information coordination remained relatively high, with a slight improvement, doctors of both care levels reported a worse experience of cross-level clinical management coordination, particularly of care consistency (repetition of test) and accessibility to PC and, of general perception, which was worse in SC doctors. There was also a worsening in organisational (institutional support, set objectives, time available for coordination), attitudinal (job satisfaction) and interactional factors (knowledge between doctors). The use of ICT-based coordination mechanisms such as shared electronic medical records and electronic consultations between PC and SC increased, while the participation in virtual joint clinical conferences was limited. Conclusions: Results show a slight improvement in clinical information but also less expected setbacks in some dimensions of clinical management coordination and in the perception of clinical coordination, suggesting that the increased use of some ICT-based coordination mechanisms did not counteract the effect of the worsened organisational, interactional, and attitudinal factors during the pandemic. Strategies are needed to facilitate direct communication, to improve conditions for the effective use of mechanisms and policies to protect healthcare professionals and services in order to better cope with new crises.
• dc.format.mimetype application/pdf
• dc.identifier.citation Campaz-Landazabal D, Vargas I, Sánchez E, Cots F, Plaja P, Perez-Castejón JM, Sánchez-Hidalgo A, et al. Has cross-level clinical coordination changed in the context of the pandemic? The case of the Catalan health system. BMC Health Serv Res. 2024 Aug 21;24(1):959. DOI: 10.1186/s12913-024-11445-7
• dc.identifier.doi http://dx.doi.org/10.1186/s12913-024-11445-7
• dc.identifier.issn 1472-6963
• dc.identifier.uri http://hdl.handle.net/10230/69836
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.relation.ispartof BMC Health Serv Res. 2024 Aug 21;24(1):959
• dc.rights © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword COVID-19
• dc.subject.keyword Care coordination
• dc.subject.keyword Clinical coordination
• dc.subject.keyword Coordination mechanisms
• dc.subject.keyword ICT-based coordination mechanism
• dc.subject.keyword Pandemic
• dc.subject.keyword Primary care
• dc.subject.keyword Secondary care
• dc.title Has cross-level clinical coordination changed in the context of the pandemic? The case of the Catalan health system
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion