Aller Hernández Marta Beatriz, Vargas Lorenzo Ingrid, Sánchez Pérez Inma, Henao Martínez Diana, Coderch de Lassaletta Jordi, Llopart López Josep Ramon, Ferran Mercadé Manel, Colomés Figuera Lluís, Vázquez Navarrete M Luisa
Grupo de Recerca en Politique de Salut i Serveis Sanitaris (GRPSS), Servei d'Estudis i Prospectives en Politiques de Salut (SEPPS), Consorci de Salut i Social de Catalunya (CSC), Barcelona.
Rev Esp Salud Publica. 2010 Jul-Aug;84(4):371-87. doi: 10.1590/s1135-57272010000400003.
Rapid technological advances, organizational changes in health services and the rise of complex chronic diseases mean that users receive care from a wide variety of providers, threatening continuity of care (CC). The aim is to analyse users' perception of CC, as well as their experienced elements of (dis)continuity in the Catalonian health services.
Cross-sectional study by means ofa questionnaire survey to a sample of 200 healthcare users attended by more than one level of care for the same condition in the previous 3 months. The survey was conducted in Barcelona and Baix Empordà, between March and June 2009. The applied questionnaire collected first, the users' trajectories within health services and second, their perception of CC using a scale. A descriptive data analysis was conducted.
Important elements of relational continuity were identified (86.4 and 83.5% of users were attended in the last year, respectively, by the same physician of primary and secondary care). However, potential elements of discontinuity were identified relating to transfer of clinical information (29.1% and 21.3% of users perceived that secondary care professionals were unaware of their comorbidities and the results of medical tests ordered by physicians of primary care, respectively), coherence of care (levels of referral to primary care of 51.2 %) and accessibility between levels of care (37.8 and 17.6% considered long or excessive waiting time for secondary and primary care, respectively).
The results point to aspects of care, as accessibility and information transfer between professionals that could act as barriers for continuity and would require improvements in the coordination strategies of the health providers.
快速的技术进步、卫生服务的组织变革以及复杂慢性病的增多意味着用户从各种各样的提供者那里接受护理，这对护理连续性（CC）构成了威胁。目的是分析用户对护理连续性的看法，以及他们在加泰罗尼亚卫生服务中体验到的（不）连续性要素。
采用问卷调查进行横断面研究，对200名在过去3个月内因同一病情接受过不止一级护理的医疗保健用户进行抽样调查。调查于2009年3月至6月在巴塞罗那和baix Empordà进行。所应用的问卷首先收集用户在卫生服务中的就医轨迹，其次使用一个量表收集他们对护理连续性的看法。进行了描述性数据分析。
确定了关系连续性的重要要素（分别有86.4%和83.5%的用户在去年由同一位初级和二级护理医生诊治）。然而，也发现了与临床信息传递（分别有29.1%和21.3%的用户认为二级护理专业人员不了解他们的合并症以及初级护理医生所开医学检查的结果）、护理连贯性（转诊到初级护理的比例为51.2%）以及不同护理级别之间的可及性（分别有37.8%和17.6%的用户认为二级和初级护理的等待时间长或过长）相关的潜在不连续性要素。
结果指出了护理方面的问题，如专业人员之间的可及性和信息传递，这些可能成为连续性的障碍，需要改进卫生服务提供者的协调策略。
