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[Current situation of children with medical complexity: An experience between primary and hospital care]
Miguel Ángel Monroy Tapiador1, Francisco José Climent Alcalá2, Aroa Rodríguez Alonso2
1Centro de Salud Universitario «Reina Victoria», Madrid, España.
Insights
Primary care physicians and families report poor coordination and insufficient training for children with medical complexity. Enhancing primary care support and communication is crucial for improving care continuity.
Area of Science:
- Pediatrics
- Healthcare Management
- Public Health
Background:
- Children with medical complexity (CMC) require coordinated care across multiple settings.
- Primary Care (PC) plays a vital role in managing CMC, but its effectiveness is often questioned.
- Gaps in training and communication can hinder optimal care for CMC.
Purpose of the Study:
- To assess the perspectives of physicians and families regarding the care of CMC in Primary Care.
- To identify challenges and areas for improvement in the management of CMC within the PC setting.
Main Methods:
- An observational, descriptive, and cross-sectional study was conducted.
- Validated surveys (face-to-face and online) were administered to families and PC physicians.
- Likert scales were used to measure satisfaction with training, education, and management of CMC.
Main Results:
- Families reported a lack of care coordination (73.6%) and low confidence in PC (50%).
- PC physicians reported insufficient training (96.5%) and experience (93%) in managing CMC, along with poor communication with hospitals (80.5%).
- Both groups identified a lack of consultation time as a significant issue.
Conclusions:
- A significant disconnect exists between PC and hospital care, impacting the continuity of care for CMC.
- Interventions are needed to improve PC professionals' training, technical support, and consultation time for CMC.
- Strengthening PC's role requires enhanced education and resources to better support these vulnerable children and their families.
Objective:
To analyze the assessment of the care of children with medical complexity (CMC) in Primary Care (PC), from the point of view of their doctors and their families.
Design:
Observational, descriptive and transversal study. SITE: PC Pediatrics and Complex Chronic Pathology Unit (UPCC) of Hospital Universitario La Paz (HULP).
Participants:
Patients and relatives of the UPCC and their PC physicians of the Community of Madrid (CAM).
Interventions:
Face-to-face and online validated surveys were conducted.
Main Measurements:
Degree of satisfaction in the training, education and specific management of the CMC according to Likert-type scales.
Results:
Fifty-three families and 170 PC physicians (96.5% pediatricians) were surveyed. The results of the family survey reveal lack of coordination between levels of care (73.6%), little confidence in the first level of care, and an impression of poor problem-solving capacity by PC pediatricians (50%). Among PC physicians, there is little training in the follow-up of CMC (96.5%), little experience in their management (93%) and insufficient communication with the hospital (80.5%). Lack of time in consultations is a common problem, perceived by pediatricians and patients.
Conclusions:
The lack of coordination between PC and Hospital Care is detected as an important problem in the continuity of care at CMC. Interventions are needed to improve this coordination. The PC is close to the family but needs to improve the education and training of professionals in health problems and technical support from CMC, as well as increase the time necessary for their care.
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