title: [Continuity of care between levels perceived by users of the health system in Catalonia, Spain].
abstract: BACKGROUND
  Rapid technological advances, organizational changes in health services and the rise of complex chronic diseases mean that users receive care from a wide variety of providers, threatening continuity of care (CC). The aim is to analyse users' perception of CC, as well as their experienced elements of (dis)continuity in the Catalonian health services.
  
  
  METHODS
  Cross-sectional study by means ofa questionnaire survey to a sample of 200 healthcare users attended by more than one level of care for the same condition in the previous 3 months. The survey was conducted in Barcelona and Baix Empordà, between March and June 2009. The applied questionnaire collected first, the users' trajectories within health services and second, their perception of CC using a scale. A descriptive data analysis was conducted.
  
  
  RESULTS
  Important elements of relational continuity were identified (86.4 and 83.5% of users were attended in the last year, respectively, by the same physician of primary and secondary care). However, potential elements of discontinuity were identified relating to transfer of clinical information (29.1% and 21.3% of users perceived that secondary care professionals were unaware of their comorbidities and the results of medical tests ordered by physicians of primary care, respectively), coherence of care (levels of referral to primary care of 51.2 %) and accessibility between levels of care (37.8 and 17.6% considered long or excessive waiting time for secondary and primary care, respectively).
  
  
  CONCLUSIONS
  The results point to aspects of care, as accessibility and information transfer between professionals that could act as barriers for continuity and would require improvements in the coordination strategies of the health providers.
authors.affiliation: Grupo de Recerca en Politique de Salut i Serveis Sanitaris (GRPSS), Servei d'Estudis i Prospectives en Politiques de Salut (SEPPS), Consorci de Salut i Social de Catalunya (CSC), Barcelona. maller@consorci.org
authors.forename: Marta Beatriz
authors.initials: MB
authors.lastname: Aller Hernández
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vargas Lorenzo
authors.forename: Inma
authors.initials: I
authors.lastname: Sánchez Pérez
authors.forename: Diana
authors.initials: D
authors.lastname: Henao Martínez
authors.forename: Jordi
authors.initials: J
authors.lastname: Coderch de Lassaletta
authors.forename: Josep Ramon
authors.initials: JR
authors.lastname: Llopart López
authors.forename: Manel
authors.initials: M
authors.lastname: Ferran Mercadé
authors.forename: Lluís
authors.initials: L
authors.lastname: Colomés Figuera
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Vázquez Navarrete
mesh_terms: D003266:Continuity of Patient Care; D003627:Data Interpretation, Statistical; D019538:Health Care Surveys; D006801:Humans; D005791:Patient Care / Q000592:standards*; D010465:Perception; D010817:Physician-Patient Relations; D011320:Primary Health Care; D013030:Spain; D011795:Surveys and Questionnaires