The burden of non-SARS-CoV2 viral lower respiratory tract infections in hospitalized children in Barcelona (Spain): A long-term, clinical, epidemiologic and economic study.

Background: Viral lower respiratory tract infections (LRTI) are the leading cause of hospitalization in children. In Catalonia (Spain), information is scarce about the burden of viral LRTIs in paediatric hospitalizations. The aim of this study is to describe epidemiological, clinical, virological and economic features of paediatric hospitalizations due to viral LRTI.

Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona.

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d'Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves.

Doctors' opinion on the contribution of coordination mechanisms to improving clinical coordination between primary and outpatient secondary care in the Catalan national health system.

Background: Clinical coordination is considered a health policy priority as its absence can lead to poor quality of care and inefficiency. A key challenge is to identify which strategies should be implemented to improve coordination. The aim is to analyse doctors' opinions on the contribution of mechanisms to improving clinical coordination between primary and outpatient secondary care and the factors influencing their use.

Doctors' opinions on clinical coordination between primary and secondary care in the Catalan healthcare system.

Objective: To analyse doctors' opinions on clinical coordination between primary and secondary care in different healthcare networks and on the factors influencing it.

Methods: A qualitative descriptive-interpretative study was conducted, based on semi-structured interviews. A two-stage theoretical sample was designed: 1) healthcare networks with different management models; 2) primary care and secondary care doctors in each network.

Continuity of clinical management and information across care levels: perceptions of users of different healthcare areas in the Catalan national health system.

Background: The integration of health care has become a priority in most health systems, as patients increasingly receive care from several professionals in various different settings and institutions, particularly those with chronic conditions and multi-morbidities. Continuity of care is defined as one patient experiencing care over time as connected and coherent with his or her health needs and personal circumstances. The objective is to analyse perceptions of continuity of clinical management and information across care levels and the factors influencing it, from the viewpoint of users of the Catalan national health system.

Development and testing of indicators to measure coordination of clinical information and management across levels of care.

Background: Coordination across levels of care is becoming increasingly important due to rapid advances in technology, high specialisation and changes in the organization of healthcare services; to date, however, the development of indicators to evaluate coordination has been limited. The aim of this study is to develop and test a set of indicators to comprehensively evaluate clinical coordination across levels of care.

Methods: A systematic review of literature was conducted to identify indicators of clinical coordination across levels of care.

The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients.

Background: Integrated health care networks (IHN) are promoted in numerous countries as a response to fragmented care delivery by providing a coordinated continuum of services to a defined population. However, evidence on their effectiveness and outcome is scarce, particularly considering continuity across levels of care; that is the patient's experience of connected and coherent care received from professionals of the different care levels over time. The objective was to analyse the chronic obstructive pulmonary disease (COPD) patients' perceptions of continuity of clinical management and information across care levels and continuity of relation in IHN of the public health care system of Catalonia.

[Adaptation and validation of the CCAENA(©) scale for the measurement of continuity of care between healthcare levels in Colombia and Brazil].

Objective: To adapt and to validate the scale of the questionnaire Continuity of Care between Care Levels (CCAENA(©)) in the context of the Colombian and Brazilian health systems.

Methods: The study consisted of two phases: 1) adaptation of the CCAENA(©) scale to the context of each country, which was tested by two pretests and a pilot test, and 2) validation by means of application of the scale in a population survey in Colombia and Brazil. The following psychometric properties were analyzed: construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha and item-rest correlations), the multidimensionality of the scales (Spearman correlation coefficients), and known group validity (chi-square test).

[Immigrants' access to health care in Spain: a review].

Background: An important proportion of the population in Spain is immigrant and the international literature indicates their inadequate access to health services. The objective is to contribute to improving the knowledge on access to health care of the immigrant population in Spain.

Methods: Review of original papers published (1998-2012) on access to health services of the immigrant population in Spain published in Medline and MEDES.

[The impact of the economic crisis on the health and healthcare of the immigrant population. SESPAS report 2014].

Despite the economic crisis, the immigrant population of Spain continues to be high, with 5.7 million persons (11.4%).

A tool for assessing continuity of care across care levels: an extended psychometric validation of the CCAENA questionnaire.

Background: The CCAENA questionnaire was developed to assess care continuity across levels from the patients' perspective. The aim is to provide additional evidence on the psychometric properties of the scales of this questionnaire.

Methods: Cross-sectional study by means of a survey of a random sample of 1500 patients attended in primary and secondary care in three health care areas of the Catalan health care system.

Development of quality of care indicators from systematic reviews: the case of hospital delivery.

Background: The objective of this research is to generate quality of care indicators from systematic reviews to assess the appropriateness of obstetric care in hospitals.

Methods: A search for systematic reviews about hospital obstetric interventions, conducted in The Cochrane Library, clinical evidence and practice guidelines, identified 303 reviews. We selected 48 high-quality evidence reviews, which resulted in strong clinical recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

A first approach to differences in continuity of care perceived by immigrants and natives in the Catalan public healthcare system.

Objective: To compare immigrants' and natives' perceptions of relational, managerial and informational continuity of care and to explore the influence of the length of stay on immigrants' perceptions of continuity.

Methods: Cross-sectional study based on a survey of a random sample of 1,500 patients, of which 22% (331) were immigrants. The study area was made up by three healthcare areas of the Catalan healthcare system.

A comprehensive analysis of patients' perceptions of continuity of care and their associated factors.

Objective: To determine the patients' perceived degree of continuity of care between primary and secondary care and to identify contextual and individual factors that influence patients' perceptions of continuity of care.

Design: Cross-sectional study by means of a survey of patients attended to in primary and secondary care.

Setting: Three health-care areas of the Catalonian public health-care system.

Factors associated to experienced continuity of care between primary and outpatient secondary care in the Catalan public healthcare system.

Objective: To analyze patient's reported elements of relational, informational and managerial (dis)continuity between primary and outpatient secondary care and to identify associated factors.

Methods: Cross-sectional study by means of a survey of a random sample of 1500 patients attended in primary and secondary care for the same condition. The study settings consisted of three health areas of the Catalan health system.

What do we know about patients' perceptions of continuity of care? A meta-synthesis of qualitative studies.

Objective: The increasing complexity in healthcare delivery might impede the achievement of continuity of care, being defined as 'one patient experiencing care over time as coherent and linked'. This article aims to improve the knowledge on patients' perceptions of relational (RC), informational (IC) and management continuity (MC) across care levels.

Design: A descriptive, qualitative meta-synthesis was conducted based on a literature search in various electronic databases using the subject heading 'continuity of care' and linked key terms.

[Design and validation of a questionnaire to measure continuity between care levels from the user's perspective].

Objectives: To design and validate an instrument that measures continuity between levels of care from the user's perspective to be applied in any healthcare system providing a continuum of care.

Methods: 1) A questionnaire for the measurement of continuity of care was designed, based on a literature review, and 2) the questionnaire was validated using an expert group, two pretests and a pilot test to a sample of 200 healthcare users. We assessed the questionnaire's comprehensibility, content validity and interviewer burden, as well as the reliability and construct validity of the scale.