Efficiency as a determinant of loyalty among users of a Community of Clinical Practice : a comparative study between the implementation and consolidation phases
Lacasta Tintorer, David (Universitat Autònoma de Barcelona)
Manresa, J. M (Universitat Autònoma de Barcelona)
Jiménez-Zarco, Ana (Universitat Oberta de Catalunya. Estudios de Economía y Empresa)
Rodríguez-Blanco, Teresa (Universitat Autònoma de Barcelona)
Flayeh Beneyto, Souhel (Institut Català de la Salut)
Torán Montserrat, Pere (Universitat de Girona. Departament de Ciències Mèdiques)
Mundet-Tudurí, Xavier (Universitat Autònoma de Barcelona)
Saigí Rubió, Francesc (Universitat Oberta de Catalunya. Estudis de Ciències de la Salut)

Data:	2020
Resum:	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 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. Two 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. We 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Remote consultation ; Primary health care ; Problem solving ; Telemedicine ; Referral and consultation ; Continuing medical education
Publicat a:	BMC family practice, Vol. 21 (january 2020) , ISSN 1471-2296

DOI: 10.1186/s12875-020-1081-x
PMID: 31980016

12 p, 720.2 KB

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