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[Role of paediatrics in primary care and coordination with specialist care]
M J Pueyo1, L Baranda, J Valderas
1Departament de Salut, Generalitat de Cataluña, Barcelona, España. mjpueyo@catsalut.cat
Insights
Primary care paediatricians embrace comprehensive care despite hospital-based training. However, challenges in training adaptation, recognition, and specialist coordination impact their practice.
Area of Science:
- Pediatric Healthcare
- Primary Care Medicine
- Medical Education
Context:
- Pediatricians receive extensive hospital-based training with limited primary care exposure.
- Understanding pediatrician perceptions of primary care attributes is crucial for effective healthcare delivery.
Purpose:
- To explore primary care pediatricians' perceptions and experiences regarding the core attributes of primary care (first contact, comprehensiveness, continuity).
- To identify challenges and facilitators in the performance of primary care pediatricians' roles.
Summary:
- Paediatricians recognize the importance of comprehensive care, including contextual factors of the child.
- They report inadequate training for primary care, poor social/institutional recognition, and unsatisfactory coordination with specialists.
- Personal knowledge, shared training, and in-person clinical sessions were identified as beneficial.
Impact:
- Addressing training gaps and improving recognition can enhance the quality of pediatric primary care.
- Improving coordination with specialists is essential for seamless patient management.
- Findings can inform curriculum development and policy changes to better support primary care pediatricians.
Objectives:
Primary care (PC) paediatricians are trained mainly in the hospital setting, with little contact with PC. This study aimed to find out what perceptions and experiences they have on the attributes of PC (first contact, comprehensiveness and continuity of care) that are assumed and performed by PC paediatricians.
Material And Methods:
A qualitative study was performed based on focus groups and semi-structured individual interviews with paediatricians with pre-defined sociodemographic and speciality training characteristics. Two focus groups (5 and 4 people each) and 5 interviews were made. Participants responded to two questions: how would you explain your function as a primary care paediatrician? and what is your opinion on the relationship between primary care paediatricians and the specialists to whom your patients are referred? The conversations of the groups and interviews were recorded and transcribed, and a content analysis was performed.
Results:
Paediatricians assume that PC must be comprehensive, and take into account the context of the child. Paediatricians declare a lack in their training and poor social and institutional recognition. Coordination with specialists and the transfer of information are not satisfactory. Helpful factors are personal knowledge, the shared training and the face-to-face clinical sessions.
Conclusion:
Despite their hospital-based training, paediatricians assume the attributes of PC. Difficulties in performing their function include poor adaptation of their training to PC, and little institutional and social recognition. Coordination with specialists is not satisfactory. Approaching these difficulties can help maintaining a high quality level in the care of the paediatric population.
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