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Revista de salud publica del Paraguay

versão impressa ISSN 2224-6193versão On-line ISSN 2307-3349


VILLALBA, Bernardita; MOLINAS, Fabio A  e  CABRAL-BEJARANO, MS. Factors that facilitate or hinder the Continuity of Care in the Service Network of the Presidente Hayes Department according to attributes of the RIISS, Paraguay, 2018-2019. Rev. salud publica Parag. [online]. 2020, vol.10, n.2, pp.50-58. ISSN 2307-3349.


The study is developed in the Department of Presidente Hayes XV Sanitary Region dependent on the Ministry of Public Health, in a rural area characterized by weak communication, availability of resources and weak training processes.


to evaluate dynamics and factors that facilitate or hinder the articulation, interaction and coordination of health teams between levels of care for the continuity of care in the department of Presidente Hayes, Paraguay.


A descriptive, quantitative, cross-sectional observational study that explores, through semi-structured questions, factors that hinder or facilitate continuity of care, using the application of 13 attributes of the RIISS / PAHO as a frame of reference. Individual interviews were conducted with 25 key actors (professionals and health personnel) playing roles in the first level of care and hospital reference levels, using a semi-structured questionnaire to explore dimensions related to continuity of care (information, mechanisms of communication, management coordination and training).


The findings indicate communication difficulties, discontinuity in the use of reference and return instruments that condition the effectiveness of the patient referral processes, knowledge, availability of standards and protocols contribute in many cases to decision-making. The opportunities for joint training between first-level teams and hospital teams are insufficient, connectivity difficulties and restricted use of mobile devices affect the integration of professionals between levels and the generation of changes in behavior and commitment.

Palavras-chave : Continuity; care; coordination; primary health care; Paraguay.

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