Evaluación de una guía de codificación de determinantes sociales de la salud en las consultas de atención primaria: Estudio mixto

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Atencion Primaria Pub Date : 2024-02-23 DOI:10.1016/j.aprim.2024.102878

Berta Rodoreda-Pallàs , Eva Torra Escarrer , Jaume Sanahuja Juncadella , Teresa Pampalona Cardona , Nuria Solanas Bacardit , Montserrat Vilarrubias Calaf

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Abstract

Objective

To evaluate a coding guide for social determinants of health in primary care consultations as an effective tool in the professional's daily workflow.

Design

Mixed sequential explanatory study. Formed by a quantitative part (experimental) and a qualitative part (descriptive-evaluative).

Location

All the primary care teams of the Central Catalonia Management (32 teams).

Participants and setting

All nursing, social work and medical professionals working in the 32 primary care teams of the Catalan Institute of Health in Central Catalonia from February 2023 to July 2023.

Methods

A social determinants of health coding guide was developed. This guide was created in a multidisciplinary and multicenter manner. Purposive sampling. Quantitatively, the number of diagnoses recorded by the experimental group versus the control group was counted. Qualitatively, a thematic analysis was carried out from a socio-constructivist perspective.

Results

The results were significant and satisfactory. Using a quantitative methodology, the effectiveness of the use of the guide was assessed. A significant increase in the use of the social determinants was observed in the intervention group vs. the control group, with a percentage of post-intervention use of 19.53% in the control group and 32.26% in the intervention group (P < .001). The number of diagnoses recorded increased from 312 to 1322 in the intervention group, while it remained the same in the control group. The main factors identified through qualitative methodology that may explain the effectiveness of the guideline were: 1) the effectiveness of the guideline among primary care professionals, 2) the appropriateness of the guideline by assessing its usefulness and practicality, 3) feasibility and 4) specific contributions to the improvement of the guideline.

Conclusions

The social determinants of health coding guide is effective, appropriate and can be implemented in the workflow of primary health care professionals for good recording of the social determinants of health.

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评估初级保健咨询中健康的社会决定因素编码指南：一项混合研究。

目的评估初级医疗咨询中健康的社会决定因素编码指南作为专业人员日常工作流程中的有效工具的作用。地点加泰罗尼亚中部管理部门的所有初级保健团队（32 个团队）。参与者和环境2023 年 2 月至 2023 年 7 月期间，在加泰罗尼亚中部卫生研究所的 32 个初级保健团队工作的所有护理、社会工作和医疗专业人员。该指南是以多学科和多中心的方式制定的。有目的抽样。定量方面，统计实验组与对照组记录的诊断数量。在定性方面，从社会建构主义的角度进行了专题分析。采用定量方法对指南的使用效果进行了评估。干预组与对照组相比，社会决定因素的使用率明显提高，对照组干预后的使用率为 19.53%，干预组为 32.26%（P <.001）。干预组记录的诊断次数从 312 次增加到 1322 次，而对照组保持不变。通过定性方法确定的可解释该指南有效性的主要因素有结论健康的社会决定因素编码指南是有效的、适当的，可以在初级卫生保健专业人员的工作流程中实施，以很好地记录健康的社会决定因素。

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来源期刊

Atencion Primaria 医学-医学：内科

CiteScore

2.90

自引率

8.00%

发文量

156

审稿时长

33 days

期刊介绍： Atención Primaria es una revista que publica trabajos de investigación relativos al ámbito de la atención primaria de salud. Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a la promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada para recoger y difundir la producción científica realizada desde los centros de atención primaria de salud sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria, entre otros.