SciELO - Scientific Electronic Library Online

vol.34 issue4Association between socioeconomic determinants and environmental tobacco smoke exposure in childrenAssociation between type of vehicle and the risk of provoking a collision between vehicles author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Gaceta Sanitaria

Print version ISSN 0213-9111


MIRANDA-MENDIZABAL, Andrea et al. Knowledge and use of clinical coordination mechanisms in healthcare networks in Latin America. Gac Sanit [online]. 2020, vol.34, n.4, pp.340-349.  Epub Feb 15, 2021. ISSN 0213-9111.


To analyze the level of knowledge and use, and the characteristics of use, of care coordination mechanisms in public healthcare networks of six Latin America countries.


Cross-sectional study based on a survey using the COORDENA® questionnaire with primary and secondary care doctors (348 doctors/country) of public healthcare networks in Argentina, Brazil, Chile, Colombia, Mexico and Uruguay (May-October 2015). Analyzed variables: degree of knowledge and use of information coordination (referral/reply letter, discharge report, phone, e-mail) and of clinical management coordination (shared clinical guidelines, joint meetings) mechanisms. Descriptive analyses were conducted.


Knowledge of clinical information coordination mechanisms was high in both care levels and analyzed networks as was the use of referral/reply letter. There was greater variability in the use of discharge reports (from 40.0% in Brazil to 79.4% in Mexico) and, except for Argentina, a low reception reported by primary care doctors stands out (12.3% in Colombia and 55.1% in Uruguay). In contrast, knowledge of clinical management coordination mechanisms was limited, especially among secondary care doctors. It is noteworthy, however, that adherence to clinical guidelines was high (from 83.1% in Mexico to 96.8% in Brazil), while participation in joint meetings varied widely (from 23.7% in Chile to 76.2% in Brazil). The difficulties reported in the use of the mechanisms are related to structural and organizational factors.


The limited knowledge and use of coordination mechanisms shows insufficient diffusion and implementation. Strategies to increase its use are needed, including the related factors.

Keywords : Clinical coordination; Clinical coordination mechanisms; Primary health care; Integrated health care; Latin America.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )