Do primary and secondary care doctors have a different experience and perception of cross-level clinical coordination? Results of a cross-sectional study in the Catalan National Health System (Spain)

摘要

The explanatory variables used to explore factors associated with perceiving high levels of clinical coordination were a) sociodemographic: sex, age, country of birth and medical speciality; b) employment characteristics: years working as a doctor, years working in the organization and type of contract; c) attitude towards job: satisfaction with their job in the organization d) type of area: type of management of PC and SC and type of hospital; e) interactional factors between doctors: knowing the doctors of the other care level, trusting in their clinical skills, perceiving that they influence the practice of doctors of the other level, and identifying the PC doctor as the coordinator of patient care across levels; f) organizational factors: perceiving that the organization’s management facilitates coordination, existence of objectives aimed at coordination in the organization, having enough time to dedicate to coordination during working hours, and visits of secondary care doctors to primary care centres; g) knowledge of existing coordination mechanisms in the area: shared electronic medical record (EMR) of the organization, joint clinical case conferences between primary and secondary care doctors, virtual consultations through EMR or e-mail, consultations via phone, shared protocols, care pathways or clinical guidelines, case managers or liaison nurses, and informing primary care doctors when their patients are discharged from hospital. Explanatory variables are described in Tables 1 and ​and22.