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Title: Efficiency as a determinant of loyalty among users of a community of clinical practice: a comparative study between the implementation and consolidation phases
Author: Lacasta Tintorer, David
Manresa Domínguez, Josep Maria
Jiménez Zarco, Ana Isabel  
Rodríguez Blanco, Teresa
Flayeh Beneyto, Souhel
Torán Monserrat, Pere
Mundet Tuduri, Xavier
Saigí Rubió, Francesc
Others: Universitat Autònoma de Barcelona
Institut Català de la Salut
Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol)
Universitat de Girona
Universitat Oberta de Catalunya (UOC)
Keywords: remote consultation
primary health care
problem solving
referral and consultation
continuing medical education
Issue Date: 24-Jan-2020
Publisher: BMC Family Practice
Citation: Lacasta Tintorer, D., Manresa Domínguez, J.M., Jiménez-Zarco, A.I., Rodríguez-Blanco, T., Flayeh Beneyto, S., Torán-Monserrat, P., Mundet Tuduri, X. & Saigí-Rubió, F. (2020). Efficiency as a determinant of loyalty among users of a community of clinical practice: a comparative study between the implementation and consolidation phases. BMC Family Practice, 21(), 1-12. doi: 10.1186/s12875-020-1081-x
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Abstract: 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.
Language: English
ISSN: 1471-2296MIAR
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