Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study

Objective This study explored the attributes of asthma care coordination from the perspective of healthcare professionals at different levels of care in Ecuador.Design Qualitative descriptive study. The Integrated Health Networks Model was the theoretical framework of reference. Narrative analysis w...

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Main Authors: Max Bachmann, Philip Cooper, Carolina Barbosa, Maria Jose Cisneros-Caceres, Emily Granadillo, Adriana Romero-Sandoval, Ana Luiza Barreto de Oliveira, Gabriela Pimentel Pinheiro, Alvaro Cruz, Jose Montalvo-Yepez, Guillermo Gómez-Urrego, Rejane Ferreira, Natalia Cristina Romero-Sandoval
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e084803.full
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author Max Bachmann
Philip Cooper
Carolina Barbosa
Maria Jose Cisneros-Caceres
Emily Granadillo
Adriana Romero-Sandoval
Ana Luiza Barreto de Oliveira
Gabriela Pimentel Pinheiro
Alvaro Cruz
Jose Montalvo-Yepez
Guillermo Gómez-Urrego
Rejane Ferreira
Natalia Cristina Romero-Sandoval
author_facet Max Bachmann
Philip Cooper
Carolina Barbosa
Maria Jose Cisneros-Caceres
Emily Granadillo
Adriana Romero-Sandoval
Ana Luiza Barreto de Oliveira
Gabriela Pimentel Pinheiro
Alvaro Cruz
Jose Montalvo-Yepez
Guillermo Gómez-Urrego
Rejane Ferreira
Natalia Cristina Romero-Sandoval
author_sort Max Bachmann
collection DOAJ
description Objective This study explored the attributes of asthma care coordination from the perspective of healthcare professionals at different levels of care in Ecuador.Design Qualitative descriptive study. The Integrated Health Networks Model was the theoretical framework of reference. Narrative analysis was used to identify significant phrases from the interviews.Setting Healthcare professionals involved in the care of patients with asthma in primary care, specialists, emergency and management in three Ecuadorian cities between 2019 and 2021.Participants 25 healthcare professionals participated in semistructured in-depth interviews. Convenience sampling was used.Results Participants highlighted the scarce use of institutional documents for the referral of asthma patients from the first level to specialists and vice versa, duplication of tests and medical prescriptions, and lack of appointment availability that limits access to specialised care. From the first level, they considered that specialists do not return patients and specialists stressed that the first level does not have enough training to follow asthma patients. Managers highlighted the system’s inability to assign appointments on time and failures in administrative processes for follow-up. Emergency professionals did not have access to the medical records of patients suffering from asthma attacks.Conclusions The lack of shared objectives and effective communication between different levels of care for the follow-up of asthma patients were attributes of asthma care coordination perceived by healthcare professionals at different levels of care in Ecuador. The Ecuadorian health system should consider these to improve its performance.
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spelling doaj-art-c67f22c1160e4bd2b3fab38b78c1848c2025-08-20T02:36:34ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-084803Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative studyMax Bachmann0Philip Cooper1Carolina Barbosa2Maria Jose Cisneros-Caceres3Emily Granadillo4Adriana Romero-Sandoval5Ana Luiza Barreto de Oliveira6Gabriela Pimentel Pinheiro7Alvaro Cruz8Jose Montalvo-Yepez9Guillermo Gómez-Urrego10Rejane Ferreira11Natalia Cristina Romero-Sandoval12professor of health services researchSchool of Medicine, International University of Ecuador, Quito, EcuadorCollective Health Institute, Federal University of Bahia, Salvador, BrazilSchool of Medicine, International University of Ecuador, Quito, EcuadorSchool of Medicine, International University of Ecuador, Quito, EcuadorDepartment of Medicine, Red Groups in Latin America and Africa, Barcelona, SpainCollective Health Institute, Federal University of Bahia, Salvador, BrazilDepartment of Medicine, ProAR Foundation, Salvador, BrazilCollective Health Institute, Federal University of Bahia, Salvador, Brazil1 School of Medicine, Universidad Internacional del Ecuador, Quito, Pichincha, Ecuador1 School of Medicine, Universidad Internacional del Ecuador, Quito, Pichincha, Ecuador3 GRAAL, Grup`s de Recerca d` Amèrica i Àfrica Llatines, Barcelona, Spain1 School of Medicine, Universidad Internacional del Ecuador, Quito, Pichincha, EcuadorObjective This study explored the attributes of asthma care coordination from the perspective of healthcare professionals at different levels of care in Ecuador.Design Qualitative descriptive study. The Integrated Health Networks Model was the theoretical framework of reference. Narrative analysis was used to identify significant phrases from the interviews.Setting Healthcare professionals involved in the care of patients with asthma in primary care, specialists, emergency and management in three Ecuadorian cities between 2019 and 2021.Participants 25 healthcare professionals participated in semistructured in-depth interviews. Convenience sampling was used.Results Participants highlighted the scarce use of institutional documents for the referral of asthma patients from the first level to specialists and vice versa, duplication of tests and medical prescriptions, and lack of appointment availability that limits access to specialised care. From the first level, they considered that specialists do not return patients and specialists stressed that the first level does not have enough training to follow asthma patients. Managers highlighted the system’s inability to assign appointments on time and failures in administrative processes for follow-up. Emergency professionals did not have access to the medical records of patients suffering from asthma attacks.Conclusions The lack of shared objectives and effective communication between different levels of care for the follow-up of asthma patients were attributes of asthma care coordination perceived by healthcare professionals at different levels of care in Ecuador. The Ecuadorian health system should consider these to improve its performance.https://bmjopen.bmj.com/content/14/12/e084803.full
spellingShingle Max Bachmann
Philip Cooper
Carolina Barbosa
Maria Jose Cisneros-Caceres
Emily Granadillo
Adriana Romero-Sandoval
Ana Luiza Barreto de Oliveira
Gabriela Pimentel Pinheiro
Alvaro Cruz
Jose Montalvo-Yepez
Guillermo Gómez-Urrego
Rejane Ferreira
Natalia Cristina Romero-Sandoval
Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study
BMJ Open
title Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study
title_full Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study
title_fullStr Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study
title_full_unstemmed Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study
title_short Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study
title_sort ecuadorian healthcare professionals perspectives on attributes of asthma care coordination a qualitative study
url https://bmjopen.bmj.com/content/14/12/e084803.full
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