ABSTRACT
El propósito de este proyecto es obtener un instrumento de medida para evaluar la cultura preventiva en las instituciones hospitalarias en Cataluña. Al realizar una amplia búsqueda bibliográfica se concluye que no disponemos de ningún instrumento validado que sea útil a este propósito por lo que se decide iniciar el diseño y la validación de un cuestionario en catalán, que permita medir los diferentes aspectos relacionados con la cultura preventiva que los centros aplican en su relación con los trabajadores. Se inicia la fase de diseño a cargo de un grupo de profesionales expertos en la materia hasta obtener un instrumento que cumpla las características de Fiabilidad y Validez que garanticen sus propiedades psicométricas, garantizando un exhaustivo proceso de validación
The aim of this study is to obtain a measuring tool for evaluating health promotion and safety culture in Catalan hospitals institutions. Once a wide bibliographic research was done/ provided, it was concluded that there is no useful validated tool for our purpose objective. In order to evaluate the different subjects related to health promotion and safety culture, it was decided to initiate the design and validation of a new questionnaire written in Catalan language. The initial stage / phase of the questionnaire was designed by an expert professional group in order to initiate the validation process and to obtain a tool easy to understand, with an exhaustive face and content validity which ensures psychometric properties
Subject(s)
Humans , Preventive Health Services , Organizational Culture , Health Promotion/organization & administration , Health Promotion/standards , Psychometrics , Surveys and Questionnaires/standardsABSTRACT
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Subject(s)
Continuity of Patient Care , Health Care Surveys , Patient Care/standards , Primary Health Care , Data Interpretation, Statistical , Humans , Perception , Physician-Patient Relations , Spain , Surveys and QuestionnairesABSTRACT
Fundamentos: Los avances tecnológicos, cambios organizativos de los servicios y el aumento de las enfermedades crónicas complejas favorecen que los usuarios del sistema de salud sean atendidos por un elevado número de proveedores, amenazando la continuidad asistencial (CA). El objetivo es analizar la valoración de la CA de los usuarios e identificar elementos de (dis)continuidad a partir de sus experiencias en los servicios de salud de Cataluña. Métodos: Estudio transversal, mediante encuesta a 200 usuarios que utilizaron dos niveles asistenciales en los últimos tres meses por un mismo motivo. La encuesta se realizó en Barcelona y Baix Empordà entre los meses de marzo y junio de 2009. Se aplicó un cuestionario que recoge la trayectoria de los usuarios en los servicios de salud y su valoración de la CA, mediante una escala. Se realizó un análisis descriptivo de los resultados. Resultados: Se identifican elementos de continuidad de relación (86,4% y el 83,5% fueron atendidos, respectivamente, por un único médico de atención especializada y de atención primaria en el último año). Por el contrario, se identifican elementos de discontinuidad en la transferencia de información clínica (29,1% y el 21,3% consideró que el médico de la atención especializada desconocía sus comorbilidades y las pruebas realizadas en la atención primaria, respectivamente), en la coherencia del cuidado (niveles de contrarreferencia de 51,2%) y en la accesibilidad entre niveles (37,8% y 17.6% consideraron largo o excesivo el tiempo de espera en atención especializada y primaria, respectivamente). Conclusiones: Se identifican aspectos de la provisión, como accesibilidad y transferencia de información entre profesionales, que podrían indicar barreras a la continuidad y la necesidad de introducir mejoras en las estrategias de coordinación asistencial de las organizaciones sanitarias(AU)
Background: 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. Methods: Cross-sectional study by means of a 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. Results: 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). Conclusions: 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(AU)
