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Referral and care-coordination study in Chile. Health Policy and Planning. 2018. https://europepmc.org/articles/PMC5894081?pdf=render", "country_ids": [ "CHL" ], "coverage_domains": [ "authoritative_review", "governance", "hospital_organization", "market_structure", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "only half of secondary care doctors", "institution": "Health Policy and Planning", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "only half of secondary care doctors", "source_word_count": 6 }, "material_id": "material:fdbbe697af71ce01f7819d97", "notes": [ "Do not generalize the two-Santiago-network findings to all Chile or treat them as an administrative referral-completion rate." ], "origin": "country-evidence-improvement-sources", "period": "Study published 2018; two-network physician study, not a national administrative series", "publication_date": null, "publication_year": 2018, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "59cd6b86078425f813aebd5012f5cdbeb4822195bd44f92018643771efaa33b3", "response_sha256": "59cd6b86078425f813aebd5012f5cdbeb4822195bd44f92018643771efaa33b3" }, "statement": "In two Santiago public networks, the study reports limited referral-letter and reply-information exchange between care levels. These are observed study findings in a bounded sample, not national referral-completion rates or a causal evaluation of network design.", "tags": [], "territory": "Two public health-service networks in Santiago; 348 doctors", "title": "Barriers of access to care in a managed competition model", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://europepmc.org/articles/PMC5894081?pdf=render" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Biblioteca del Congreso Nacional de Chile. Decreto 140: Reglamento Orgánico de los Servicios de Salud. https://www.bcn.cl/leychile/navegar?i=237231", "country_ids": [ "CHL" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "networks", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "organizar, administrar y gestionar la red asistencial", "institution": "Biblioteca del Congreso Nacional de Chile", "locator": { "locator_type": "legal_article_anchor", "source_word_anchor": "organizar, administrar y gestionar la red asistencial", "source_word_count": 7 }, "material_id": "material:aaeb5a5df09cd8171ac1c6f3", "notes": [ "Treat the legal allocation as formal authority. 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It cannot estimate national referral completion or generalize to other conditions.", "tags": [], "territory": "351 adults in FONASA networks studied during cancer diagnosis in Chile", "title": "Delays and detours during cancer diagnosis in Chile, Colombia and Ecuador", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://europepmc.org/articles/PMC13059593?pdf=render" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Health Organization. Evaluation of the WHO Special Programme on Primary Health Care: Chile case study. 2025. https://cdn.who.int/media/docs/default-source/evaluation-office/chile-case-study_sp-phc_final-for-web.pdf?download=true&sfvrsn=62cc50f7_3", "country_ids": [ "CHL" ], "coverage_domains": [ "actors", "authoritative_review", "governance", "government_responsibilities", "hospital_organization", "networks", "patient_flows", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "municipal primary care facilities", "institution": "World Health Organization Evaluation Office", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "municipal primary care facilities", "source_word_count": 4 }, "material_id": "material:830c87aaa42858e4320330cb", "notes": [ "Keep this as a 2025 WHO case-study report; do not infer national referral completion, implementation success or effects from its reported support activities." ], "origin": "country-evidence-improvement-sources", "period": "2025 WHO case study; describes system organization and support activities through 2024", "publication_date": null, "publication_year": 2025, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "grey_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "8bbaa7fffae242d5358ae2c0e64484c4ad2080f5d360d566eaf97d0e19ba7f9c", "page_count": 37, "response_sha256": "8bbaa7fffae242d5358ae2c0e64484c4ad2080f5d360d566eaf97d0e19ba7f9c" }, "statement": "The WHO case study describes municipal primary-care facilities as the base of each Health Service network and reports technical assistance to strengthen referral and counter-referral processes in Bío-bío. It is a reported case-study description, not a national implementation or completion measure.", "tags": [], "territory": "Chile; national Health Services System and municipal primary care described in the case study", "title": "Evaluation of the WHO Special Programme on Primary Health Care: Chile case study", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://cdn.who.int/media/docs/default-source/evaluation-office/chile-case-study_sp-phc_final-for-web.pdf?download=true&sfvrsn=62cc50f7_3" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Mendez CA, Torres R. Hospital autonomy in Chile. Revista de Saúde Pública. 2010;44(2):366-370. https://www.scielosp.org/pdf/rsp/v44n2/en_19.pdf", "country_ids": [ "CHL" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "hospital_organization", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "self-managed hospitals in a network", "institution": "Revista de Saúde Pública", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "self-managed hospitals in a network", "source_word_count": 6 }, "material_id": "material:dc382a4588238f937338bd83", "notes": [ "Keep hospital-autonomy evidence historical. 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Its 2010 review does not support a current uniform autonomy assessment across Chilean hospitals.", "tags": [], "territory": "Chile self-managed public hospitals; historical policy review", "title": "Hospital autonomy in Chile: a review of the self-managed hospital policy", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.scielosp.org/pdf/rsp/v44n2/en_19.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Health Organization. Implementing the primary health care approach: a primer. 2024. https://www.ncbi.nlm.nih.gov/books/NBK618515/", "country_ids": [ "CHL" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "networks", "patient_flows", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "network manager is responsible for defining referrals", "institution": "World Health Organization", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "network manager is responsible for defining referrals and counter-referrals", "source_word_count": 9 }, "material_id": "material:dfbfa26eacb91ce1242bad6d", "notes": [ "Do not convert the described model into a national observed-flow measure." ], "origin": "country-evidence-improvement-sources", "period": "2024 primer; describes a reform model rather than adherence measurement", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "48db71602ce5180615dea98d06e9c488b883ee4618ef00cb14b9773f1b5f8cc0", "page_count": 242, "response_sha256": "48db71602ce5180615dea98d06e9c488b883ee4618ef00cb14b9773f1b5f8cc0" }, "statement": "The WHO Chile case describes a PHC-oriented model in which network management defines referrals and counter-referrals and links follow-up to primary care. It is a reported model description, not a national adherence estimate.", "tags": [], "territory": "Chile public health-service networks in the WHO case description", "title": "Implementing the primary health care approach: a primer", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.ncbi.nlm.nih.gov/books/n/who9789240090583/pdf/" }, { "kind": "embedded_source_url", "source": "URL supplied in citation", "url": "https://www.ncbi.nlm.nih.gov/books/NBK618515/" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministerio de Salud de Chile. Norma General Técnica No. 118 sobre referencia y contrarreferencia. 2011. https://www.minsal.cl/wp-content/uploads/2016/09/9_NORMA-DE-REFERENCIA-Y-CONTRAREFERENCIA.pdf", "country_ids": [ "CHL" ], "coverage_domains": [ "authoritative_review", "governance", "hospital_organization", "networks", "patient_flows", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "referencia y contrarreferencia como procesos asistenciales", "institution": "Ministerio de Salud de Chile", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "referencia y contrarreferencia como procesos asistenciales", "source_word_count": 6 }, "material_id": "material:9aaa418ae73c8097fa011767", "notes": [ "Do not describe this formal norm as evidence that patients complete referrals or receive counter-referrals." ], "origin": "country-evidence-improvement-sources", "period": "2011 technical norm; no observed adherence measure in this source", "publication_date": null, "publication_year": 2011, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "response_sha256": "77767ed9465ecb8dce9970f53feeb5ab3b020d18df91e420fd16f8876862991d" }, "statement": "The technical norm defines referral and counter-referral as coordinated processes within care networks and assigns network actors responsibilities for their management. It sets intended process design, not a national completion or bypass rate.", "tags": [], "territory": "Chile health-service networks", "title": "Norma General Técnica No. 118 sobre referencia y contrarreferencia", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.minsal.cl/wp-content/uploads/2016/09/9_NORMA-DE-REFERENCIA-Y-CONTRAREFERENCIA.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "OECD. OECD Reviews of Public Health: Chile. 2019. https://www.oecd.org/en/publications/oecd-reviews-of-public-health-chile_9789264309593-en/full-report/component-6.html", "country_ids": [ "CHL" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "facility_data", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "patient_flows", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "29 health services are responsible for", "institution": "Organisation for Economic Co-operation and Development", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "29 health services are responsible for", "source_word_count": 6 }, "material_id": "material:67d031953d8ee9ac6f556988", "notes": [ "Treat this as a 2019 national review. 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