Abstract
BackgroundA community of clinical practice called the Online Communication Tool between Primary and Hospital Care (ECOPIH) was created to enable primary care and specialist care professionals to communicate with each other in order to resolve real clinical cases, thereby improving communication and coordination between care levels. The present work seeks to analyse whether ECOPIH makes it possible to reduce the number of referrals. To that end, the objectives are: (1) To find out the degree of loyalty among ECOPIH users, by comparing the medical professionals’ profiles in the tool’s implementation phase to those in its consolidation phase. (2) To evaluate the degree of fulfilment of users’ expectations, by establishing the determining factors that had an influence on the physicians’ intention to use ECOPIH in the implementation phase and observing whether its use had an effective, direct impact on the number of patient referrals that primary care physicians made to specialist care professionals.MethodsTwo studies were conducted. Based on a survey of all the physicians in a Primary Care area, Study 1 was a descriptive study in ECOPIH’s implementation phase. Study 2 was a randomised intervention study of ECOPIH users in the tool’s consolidation phase. The results from both studies were compared. Various bivariate and multivariate statistical techniques (exploratory factor analysis, cluster analysis, logistic regression analysis and ANOVA) were used in both studies, which were conducted on a sample of 111 and 178 physicians, respectively.ResultsWe confirmed the existence of an ECOPIH user profile stable across both phases: under-50-year-old women. Regarding the second objective, there were two particular findings. First, the discriminant factors that had an influence on greater ECOPIH use were habitual Social media website and app use and Perceived usefulness for reducing costs. Second, PC professionals who were ECOPIH members made fewer referrals to SC professionals in Cardiology, Endocrinology and Gastroenterology than older PC professionals who were not ECOPIH members.ConclusionsThe use of a community of clinical practice by primary care and specialist care professionals helps to reduce the number of referrals among medical professionals.
Highlights
A community of clinical practice called the Online Communication Tool between Primary and Hospital Care (ECOPIH) was created to enable primary care and specialist care professionals to communicate with each other in order to resolve real clinical cases, thereby improving communication and coordination between care levels
The use of a community of clinical practice by primary care and specialist care professionals helps to reduce the number of referrals among medical professionals
Given that the health system is at saturation point, communication between primary care (PC) and specialist care (SC) may be difficult, slow, and ineffective [10,11,12,13], and it leads to many referrals to SC
Summary
A community of clinical practice called the Online Communication Tool between Primary and Hospital Care (ECOPIH) was created to enable primary care and specialist care professionals to communicate with each other in order to resolve real clinical cases, thereby improving communication and coordination between care levels. Given that the health system is at saturation point, communication between PC and SC may be difficult, slow, and ineffective [10,11,12,13], and it leads to many referrals to SC (hospitalisation or specialist outpatient clinics). This leads to excessive delays for appointments [14, 15] and to a significant increase in financial, time and psychological costs to physicians and patients. The scales were developed following a major review of the literature (see Table 3 in Lacasta et al [45])
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