array:24 [
  "pii" => "S0213911108760886"
  "issn" => "02139111"
  "doi" => "10.1016/S0213-9111(08)76088-6"
  "estado" => "S300"
  "fechaPublicacion" => "2008-04-01"
  "aid" => "76088"
  "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
  "copyrightAnyo" => "2008"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Gac Sanit. 2008;22 Supl 1:163-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2869
    "formatos" => array:3 [
      "EPUB" => 140
      "HTML" => 1907
      "PDF" => 822
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0213911108760898"
    "issn" => "02139111"
    "doi" => "10.1016/S0213-9111(08)76089-8"
    "estado" => "S300"
    "fechaPublicacion" => "2008-04-01"
    "aid" => "76089"
    "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2008;22 Supl 1:169-78"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2144
      "formatos" => array:3 [
        "EPUB" => 131
        "HTML" => 1539
        "PDF" => 474
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios</span>"
      "titulo" => "El control del c&#225;ncer de pulm&#243;n en Espa&#241;a&#58; un an&#225;lisis de la situaci&#243;n actual&#46; Informe SESPAS 2008"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "169"
          "paginaFinal" => "178"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Lung cancer in Spain&#58; the current situation"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Xavier Bonfill, M&#46; Teresa Puig, Ignasi Bol&#237;bar, M&#46; Jes&#250;s Quintana"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Xavier"
              "apellidos" => "Bonfill"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Teresa Puig"
            ]
            2 => array:2 [
              "nombre" => "Ignasi"
              "apellidos" => "Bol&#237;bar"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Jes&#250;s Quintana"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760898?idApp=WGSE"
    "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760898/v1_201301221349/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0213911108760874"
    "issn" => "02139111"
    "doi" => "10.1016/S0213-9111(08)76087-4"
    "estado" => "S300"
    "fechaPublicacion" => "2008-04-01"
    "aid" => "76087"
    "copyright" => "Sociedad Espa&#241;ola de Salud P&#250;blica y Administraci&#243;n Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2008;22 Supl 1:156-62"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2697
      "formatos" => array:3 [
        "EPUB" => 162
        "HTML" => 1794
        "PDF" => 741
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios&#46; La integraci&#243;n asistencial&#44; &#191;Doctor Jekyll o Mr&#46; Hyde&#63;</span>"
      "titulo" => "Integraci&#243;n y fronteras entre la atenci&#243;n sanitaria y social&#46; Informe SESPAS 2008"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "156"
          "paginaFinal" => "162"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Integration and boundaries between health and social care"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mar&#237;a Victoria Zunzunegui Pastor, Pablo L&#225;zaro, de Mercado"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Mar&#237;a Victoria"
              "apellidos" => "Zunzunegui Pastor"
            ]
            1 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "L&#225;zaro"
            ]
            2 => array:2 [
              "nombre" => "de"
              "apellidos" => "Mercado"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760874?idApp=WGSE"
    "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760874/v1_201301221349/es/main.assets"
  ]
  "es" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios&#46; La integraci&#243;n asistencial&#44; &#191;Doctor Jekyll o Mr&#46; Hyde&#63;</span>"
    "titulo" => "La gesti&#243;n de casos y de enfermedades&#44; y la mejora de la coordinaci&#243;n de la atenci&#243;n sanitaria en Espa&#241;a&#46; Informe SESPAS 2008"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "163"
        "paginaFinal" => "168"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Juan G&#233;rvas"
        "autores" => array:1 [
          0 => array:4 [
            "nombre" => "Juan"
            "apellidos" => "G&#233;rvas"
            "email" => array:1 [
              0 => "jgervasc&#64;meditex&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "M&#233;dico general&#44; Equipo CESCA&#44; Madrid&#44; Espa&#241;a"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia&#58; Juan G&#233;rvas&#46; Equipo CESCA&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Case and disease management and improved integration of healthcare services in Spain"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec13664"
          "palabras" => array:5 [
            0 => "Manejo de casos"
            1 => "Manejo de enfermedades"
            2 => "Atenci&#243;n Primaria"
            3 => "Investigaci&#243;n de servicios"
            4 => "Coordinaci&#243;n de servicios"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec13663"
          "palabras" => array:5 [
            0 => "Case management"
            1 => "Disease management"
            2 => "Primary care"
            3 => "Health services research"
            4 => "Coordination of services"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Las fronteras entre niveles sanitarios son artificiales&#44; pues se deben m&#225;s a la organizaci&#243;n de los servicios que a las necesidades de los pacientes&#46; Pero&#44; puesto que existen&#44; lo l&#243;gico es que la coordinaci&#243;n entre niveles logre superarlas para ofrecer los servicios que precisan los enfermos&#46; La gesti&#243;n de casos &#40;pacientes en situaciones peculiares&#44; como el alta hospitalaria&#41; y la gesti&#243;n de enfermedades &#40;pacientes con alguna enfermedad&#44; como la diabetes mellitus&#41; tratan de dar respuesta a los problemas de coordinaci&#243;n&#44; ya sea mediante la mejora de la estructura &#171;natural&#187; o una superestructura que se a&#241;ade a los cuidados habituales&#46; Son enormes el brillo y el atractivo de la gesti&#243;n de casos y enfermedades&#44; pero las pruebas cient&#237;ficas a su favor son d&#233;biles o inexistentes&#44; tanto en lo que se refiere al impacto en salud como a su coste&#46; Los programas de gesti&#243;n de casos&#47;enfermedades son respuestas verticales que debilitan la estructura horizontal que tenemos en Espa&#241;a&#44; la atenci&#243;n primaria&#46; La necesidad de estos programas deber&#237;a servir para justificar a&#250;n m&#225;s el desarrollo de una reforma procoordinaci&#243;n de la atenci&#243;n primaria&#44; que traslade poder&#44; responsabilidad y autonom&#237;a al m&#233;dico de cabecera&#44; de forma que pueda coordinar los servicios cl&#237;nicos y sociales que precisan los pacientes&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The boundaries between health services levels are artificial as they are answers to health organizations&#8217; problems rather than to patients&#8217; needs&#46; However&#44; given that these boundaries are in place&#44; coordination between these levels should overcome the difficulties so that patients receive the services they require&#46; Case management &#40;patients in specific situations&#44; such as hospital discharge&#41; and disease management &#40;patients with specific diseases&#44; such as diabetes&#41; aim to solve problems of coordination either by improving the organization of health services or by adding a new structure to the already existing structure&#46; These forms of management are highly attractive answers to coordination problems but have no scientific basis nor is there any empirical evidence of a positive impact on patients&#8217; health or the cost of services&#46; Case and disease management programs are vertical structures that weaken the horizontal structure in Spain&#44; i&#46;e&#46; primary care&#46; The need for case and disease management programs is an argument to push for a pro-coordination reform of primary care that gives power&#44; responsibility and autonomy to general practitioners&#44; so that they would be able to coordinate clinical and social services according to patients&#8217; needs&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:33 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Historia de la medicina"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; La&#237;n Entralgo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1994"
                        "editorial" => "Ediciones Cient&#237;ficas T&#233;cnicas"
                        "editorialLocalizacion" => "Barcelona"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is bigger better for primary care groups and truts&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Bjoke"
                            1 => "H&#46; Gravelle"
                            2 => "D&#46; Wilkin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2001"
                        "volumen" => "322"
                        "paginaInicial" => "599"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11238160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Saying goodbye to single-handed practices&#58; what patients and staff lose or gain&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;V&#46;D&#46; Hombergh"
                            1 => "Y&#46; Engels"
                            2 => "H&#46;V&#46;D&#46; Hoogen"
                            3 => "J&#46;V&#46; Doremalen"
                            4 => "W&#46;V&#46;D&#46; Bosch"
                            5 => "R&#46; Grol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/fampra/cmh714"
                      "Revista" => array:6 [
                        "tituloSerie" => "Fam Pract"
                        "fecha" => "2005"
                        "volumen" => "22"
                        "paginaInicial" => "20"
                        "paginaFinal" => "27"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15640293"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practice size and quality attaintment under the new GMS contract&#58; a cross-sectional analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Wang"
                            1 => "C&#46;A&#46; O&#8217;Donnell"
                            2 => "D&#46;F&#46; Mackay"
                            3 => "G&#46;C&#46;M&#46; Watt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Gen Pract"
                        "fecha" => "2006"
                        "volumen" => "56"
                        "paginaInicial" => "830"
                        "paginaFinal" => "835"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17132349"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La coordinaci&#243;n en el sistema sanitario y su mejora a trav&#233;s de las reformas europeas de la atenci&#243;n primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "A&#46; Rico"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SEMERGEN"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "418"
                        "paginaFinal" => "423"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;J&#46; Hunter"
                            1 => "G&#46; Fairfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1997"
                        "volumen" => "315"
                        "paginaInicial" => "50"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9233330"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case management programs in primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;A&#46; Fergurson"
                            1 => "M&#46; Weinberger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Gen Int Med"
                        "fecha" => "1998"
                        "volumen" => "13"
                        "paginaInicial" => "123"
                        "paginaFinal" => "126"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease management&#58; promises and pitfalls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Bodenheimer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199904153401511"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1999"
                        "volumen" => "340"
                        "paginaInicial" => "1202"
                        "paginaFinal" => "1205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10202174"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gesti&#243;n de enfermedades &#40;disease management&#41;&#46; Una aproximaci&#243;n integral a la provisi&#243;n de cuidados sanitarios"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Terol"
                            1 => "E&#46;F&#46; Hamby"
                            2 => "S&#46; Minue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "MEDFAM"
                        "fecha" => "2001"
                        "volumen" => "11"
                        "paginaInicial" => "47"
                        "paginaFinal" => "54"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La gesti&#243;n por procesos asistenciales integrales&#58; una estrategia necesaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Torres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2003"
                        "volumen" => "31"
                        "paginaInicial" => "561"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12783744"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La gesti&#243;n de casos &#40;y de enfermedades&#41;&#44; una organizaci&#243;n vertical de los servicios sanitarios"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SEMERGEN"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "370"
                        "paginaFinal" => "374"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n de intervenciones en atenci&#243;n primaria para mejorar el control de las enfermedades cr&#243;nicas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Sancho"
                            1 => "A&#46; Sarri&#225;"
                            2 => "D&#46; Y&#225;&#241;ez"
                            3 => "A&#46; Hern&#225;ndez"
                            4 => "M&#46;A&#46; Ovalie"
                            5 => "A&#46; Perianes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2003"
                        "editorial" => "AETS&#44; Instituto de Salud Carlos III&#44; Ministerio de Sanidad"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Hutt R&#44; Rosen R&#44; McCauley J&#46; Case-management long term conditions&#46; What impact does it have in the treatment of older people&#63; London&#58; The King&#39;s Fund&#59; 2004&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.kingsfund.org.uk/pdf/casemanagement.pdf">www&#46;kingsfund&#46;org&#46;uk&#47;pdf&#47;casemanagement&#46;pdf</a>"
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Experiencias de integraci&#243;n cl&#237;nica&#46; El equilibrio entre gesti&#243;n de casos y gesti&#243;n de enfermedades cuando solo existen enfermos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Meneu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Integraci&#243;n asistencial&#58; fundamentos&#44; experiencias y v&#237;as de avance"
                        "serieFecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "De la gesti&#243;n de lo complementario a la gesti&#243;n integral de la atenci&#243;n de salud&#58; gesti&#243;n de enfermedades e indicadores de actividad"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Peir&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Gesti&#243;n cl&#237;nica y sanitaria"
                        "paginaInicial" => "17"
                        "paginaFinal" => "87"
                        "serieFecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fundamentos y eficiencia de la atenci&#243;n m&#233;dica primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Ort&#250;n"
                            1 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1996"
                        "volumen" => "106"
                        "paginaInicial" => "97"
                        "paginaFinal" => "102"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atenci&#243;n primaria fuerte&#58; fundamento cl&#237;nico&#44; epidemiol&#243;gico y social en los pa&#237;ses desarrollados y en desarrollo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "M&#46; P&#233;rez Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Epidemiol"
                        "fecha" => "2006"
                        "volumen" => "9"
                        "paginaInicial" => "384"
                        "paginaFinal" => "400"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Moderaci&#243;n de la actividad m&#233;dica preventiva y curativa&#46; Cuatro ejemplos de necesidad de prevenci&#243;n cuaternaria en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "numero" => "Supl 1"
                        "paginaInicial" => "127"
                        "paginaFinal" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16539975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergency admission for cancer&#58; a matter of survival&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Porta"
                            1 => "E&#46; Fern&#225;ndez"
                            2 => "J&#46; Belloc"
                            3 => "N&#46; Malats"
                            4 => "M&#46; Gallen"
                            5 => "J&#46; Alonso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Cancer"
                        "fecha" => "1998"
                        "volumen" => "77"
                        "paginaInicial" => "477"
                        "paginaFinal" => "484"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9472647"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#191;C&#243;mo mejorar la atenci&#243;n a las enfermedades cr&#243;nicas&#63; Una ilustraci&#243;n en pacientes con insuficiencia card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Rodr&#237;guez Artalejo"
                            1 => "J&#46;R&#46; Banegas"
                            2 => "M&#46; Conde"
                            3 => "R&#46; Hern&#225;ndez"
                            4 => "C&#46; Rodr&#237;guez"
                            5 => "M&#46;T&#46; Olcoz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Gesti&#243;n cl&#237;nica y sanitaria"
                        "paginaInicial" => "1"
                        "paginaFinal" => "15"
                        "serieFecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2005&#46; Innovaci&#243;n en la Uni&#243;n Europea &#40;UE-15&#41; sobre la coordinaci&#243;n entre atenci&#243;n primaria y especializada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "A&#46; Rico"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "126"
                        "paginaInicial" => "658"
                        "paginaFinal" => "661"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2006&#46; Capacidad de respuesta de la atenci&#243;n primaria y redes de servicio&#46; El caso del Consorci Hospitalari de Catalunya"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "O&#46; Pan&#233;"
                            2 => "A&#46; Sicras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2006"
                        "volumen" => "38"
                        "paginaInicial" => "506"
                        "paginaFinal" => "510"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17194355"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Blendon RJ&#44; DesRoches CM&#44; Fleischfresser C&#44; Benson JM&#44; Weldon K&#44; Jovell AJ&#44; et al&#46; Confianza en el Sistema Nacional de Salud&#46; Resultados del estudio espa&#241;ol&#46; Barcelona&#58; Harvard School of Public Health y Fundaci&#243; Biblioteca Josep Laporte&#59; 2006&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.fbjoseplaporte.org/docs/trust_spanish_hcs.pdf">www&#46;fbjoseplaporte&#46;org&#47;docs&#47;trust&#95;spanish&#95;hcs&#46;pdf</a>"
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Jovell AJ&#46; El futuro de la profesi&#243;n m&#233;dica&#46; An&#225;lisis del cambio social y los roles de la profesi&#243;n m&#233;dica en el siglo XXI&#46; Barcelona&#58; Fundaci&#243; Biblioteca Josep Laporte&#59; 2001&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.fbjoseplaporte.org/docs/futuropm.pdf">www&#46;fbjoseplaporte&#46;org&#47;docs&#47;futuropm&#46;pdf</a>"
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#191;A qu&#233; incentivos responde la utilizaci&#243;n hospitalaria en el Sistema Nacional de Salud&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Peir&#243;"
                            1 => "E&#46; Bernal Delgado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "numero" => "Supl 1"
                        "paginaInicial" => "110"
                        "paginaFinal" => "116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16539973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La coordinaci&#243;n entre atenci&#243;n primaria y especializada&#58; &#191;reforma del sistema sanitario o reforma del ejercicio profesional&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Ojeda"
                            1 => "J&#46;M&#46; Freire"
                            2 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Adm Sanit"
                        "fecha" => "2006"
                        "volumen" => "4"
                        "paginaInicial" => "357"
                        "paginaFinal" => "382"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La coordinaci&#243;n entre niveles asistenciales&#58; una sistematizaci&#243;n de sus instrumentos y medidas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Terraza"
                            1 => "I&#46; Vargas"
                            2 => "M&#46;L&#46; V&#225;zquez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "485"
                        "paginaFinal" => "495"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17198628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease management&#58; panacea&#44; another false hope or something in between&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;P&#46; Gem&#237;an"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1370/afm.649"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Fam Med"
                        "fecha" => "2007"
                        "volumen" => "5"
                        "paginaInicial" => "257"
                        "paginaFinal" => "260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17548854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Can disease management target patients most likely to generate high costs&#63; The impact of comorbidity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Charlson"
                            1 => "R&#46;E&#46; Charlson"
                            2 => "W&#46; Briggs"
                            3 => "J&#46; Hollemberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11606-007-0130-7"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Gen Intern Med"
                        "fecha" => "2007"
                        "volumen" => "22"
                        "paginaInicial" => "464"
                        "paginaFinal" => "469"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17372794"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673610613815"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluaci&#243;n de una intervenci&#243;n domiciliaria en pacientes con insuficiencia card&#237;aca&#46; Resultados de un estudio aleatorizado"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Morcillo"
                            1 => "J&#46;M&#46; Valderas"
                            2 => "O&#46; Aguado"
                            3 => "J&#46; Del&#225;s"
                            4 => "D&#46; Sort"
                            5 => "R&#46; Pujades"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "2005"
                        "volumen" => "58"
                        "paginaInicial" => "618"
                        "paginaFinal" => "625"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15970116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ensayo cl&#237;nico aleatorizado para reducir hospitalizaciones y mejorar la calidad de vida de los pacientes con insuficiencia card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Brot&#243;ns"
                            1 => "M&#46; Mart&#237;nez"
                            2 => "E&#46; Ray&#237;"
                            3 => "C&#46; Morralla"
                            4 => "E&#46; Ballar&#237;n"
                            5 => "E&#46; P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2005"
                        "volumen" => "36"
                        "paginaInicial" => "280"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16194498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2005&#46; Sustituci&#243;n de la primaria por la especializada&#46; Algunas cuestiones en torno al seguimiento de los pacientes con insuficiencia card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SEMERGEN"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "125"
                        "paginaFinal" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2005&#46; Potenciar la atenci&#243;n primaria para mejorar el seguimiento de la insuficiencia card&#237;aca en los pa&#237;ses desarrollados"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "457"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16756846"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760886/v1_201301221349/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "713"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02139111/00000022000000S1/v1_201301221349/S0213911108760886/v1_201301221349/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760886?idApp=WGSE"
]
Compartir
Publique en esta revista
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Capítulo 4. Un sistema de salud integrado y centrado en los usuarios. La integración asistencial, ¿Doctor Jekyll o Mr. Hyde?
La gestión de casos y de enfermedades, y la mejora de la coordinación de la atención sanitaria en España. Informe SESPAS 2008
Case and disease management and improved integration of healthcare services in Spain
Juan Gérvas
Autor para correspondencia
jgervasc@meditex.es

Correspondencia: Juan Gérvas. Equipo CESCA.
Médico general, Equipo CESCA, Madrid, España
Leído
1206
Veces
se ha leído el artículo
425
Total PDF
781
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S0213911108760886"
  "issn" => "02139111"
  "doi" => "10.1016/S0213-9111(08)76088-6"
  "estado" => "S300"
  "fechaPublicacion" => "2008-04-01"
  "aid" => "76088"
  "copyright" => "Sociedad Espa&#241;ola de Salud P&#250;blica y Administraci&#243;n Sanitaria"
  "copyrightAnyo" => "2008"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Gac Sanit. 2008;22 Supl 1:163-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2869
    "formatos" => array:3 [
      "EPUB" => 140
      "HTML" => 1907
      "PDF" => 822
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0213911108760898"
    "issn" => "02139111"
    "doi" => "10.1016/S0213-9111(08)76089-8"
    "estado" => "S300"
    "fechaPublicacion" => "2008-04-01"
    "aid" => "76089"
    "copyright" => "Sociedad Espa&#241;ola de Salud P&#250;blica y Administraci&#243;n Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2008;22 Supl 1:169-78"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2144
      "formatos" => array:3 [
        "EPUB" => 131
        "HTML" => 1539
        "PDF" => 474
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios</span>"
      "titulo" => "El control del c&#225;ncer de pulm&#243;n en Espa&#241;a&#58; un an&#225;lisis de la situaci&#243;n actual&#46; Informe SESPAS 2008"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "169"
          "paginaFinal" => "178"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Lung cancer in Spain&#58; the current situation"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Xavier Bonfill, M&#46; Teresa Puig, Ignasi Bol&#237;bar, M&#46; Jes&#250;s Quintana"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Xavier"
              "apellidos" => "Bonfill"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Teresa Puig"
            ]
            2 => array:2 [
              "nombre" => "Ignasi"
              "apellidos" => "Bol&#237;bar"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Jes&#250;s Quintana"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760898?idApp=WGSE"
    "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760898/v1_201301221349/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0213911108760874"
    "issn" => "02139111"
    "doi" => "10.1016/S0213-9111(08)76087-4"
    "estado" => "S300"
    "fechaPublicacion" => "2008-04-01"
    "aid" => "76087"
    "copyright" => "Sociedad Espa&#241;ola de Salud P&#250;blica y Administraci&#243;n Sanitaria"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Gac Sanit. 2008;22 Supl 1:156-62"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2697
      "formatos" => array:3 [
        "EPUB" => 162
        "HTML" => 1794
        "PDF" => 741
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios&#46; La integraci&#243;n asistencial&#44; &#191;Doctor Jekyll o Mr&#46; Hyde&#63;</span>"
      "titulo" => "Integraci&#243;n y fronteras entre la atenci&#243;n sanitaria y social&#46; Informe SESPAS 2008"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "156"
          "paginaFinal" => "162"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Integration and boundaries between health and social care"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mar&#237;a Victoria Zunzunegui Pastor, Pablo L&#225;zaro, de Mercado"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Mar&#237;a Victoria"
              "apellidos" => "Zunzunegui Pastor"
            ]
            1 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "L&#225;zaro"
            ]
            2 => array:2 [
              "nombre" => "de"
              "apellidos" => "Mercado"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760874?idApp=WGSE"
    "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760874/v1_201301221349/es/main.assets"
  ]
  "es" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios&#46; La integraci&#243;n asistencial&#44; &#191;Doctor Jekyll o Mr&#46; Hyde&#63;</span>"
    "titulo" => "La gesti&#243;n de casos y de enfermedades&#44; y la mejora de la coordinaci&#243;n de la atenci&#243;n sanitaria en Espa&#241;a&#46; Informe SESPAS 2008"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "163"
        "paginaFinal" => "168"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Juan G&#233;rvas"
        "autores" => array:1 [
          0 => array:4 [
            "nombre" => "Juan"
            "apellidos" => "G&#233;rvas"
            "email" => array:1 [
              0 => "jgervasc&#64;meditex&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "M&#233;dico general&#44; Equipo CESCA&#44; Madrid&#44; Espa&#241;a"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia&#58; Juan G&#233;rvas&#46; Equipo CESCA&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Case and disease management and improved integration of healthcare services in Spain"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec13664"
          "palabras" => array:5 [
            0 => "Manejo de casos"
            1 => "Manejo de enfermedades"
            2 => "Atenci&#243;n Primaria"
            3 => "Investigaci&#243;n de servicios"
            4 => "Coordinaci&#243;n de servicios"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec13663"
          "palabras" => array:5 [
            0 => "Case management"
            1 => "Disease management"
            2 => "Primary care"
            3 => "Health services research"
            4 => "Coordination of services"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Las fronteras entre niveles sanitarios son artificiales&#44; pues se deben m&#225;s a la organizaci&#243;n de los servicios que a las necesidades de los pacientes&#46; Pero&#44; puesto que existen&#44; lo l&#243;gico es que la coordinaci&#243;n entre niveles logre superarlas para ofrecer los servicios que precisan los enfermos&#46; La gesti&#243;n de casos &#40;pacientes en situaciones peculiares&#44; como el alta hospitalaria&#41; y la gesti&#243;n de enfermedades &#40;pacientes con alguna enfermedad&#44; como la diabetes mellitus&#41; tratan de dar respuesta a los problemas de coordinaci&#243;n&#44; ya sea mediante la mejora de la estructura &#171;natural&#187; o una superestructura que se a&#241;ade a los cuidados habituales&#46; Son enormes el brillo y el atractivo de la gesti&#243;n de casos y enfermedades&#44; pero las pruebas cient&#237;ficas a su favor son d&#233;biles o inexistentes&#44; tanto en lo que se refiere al impacto en salud como a su coste&#46; Los programas de gesti&#243;n de casos&#47;enfermedades son respuestas verticales que debilitan la estructura horizontal que tenemos en Espa&#241;a&#44; la atenci&#243;n primaria&#46; La necesidad de estos programas deber&#237;a servir para justificar a&#250;n m&#225;s el desarrollo de una reforma procoordinaci&#243;n de la atenci&#243;n primaria&#44; que traslade poder&#44; responsabilidad y autonom&#237;a al m&#233;dico de cabecera&#44; de forma que pueda coordinar los servicios cl&#237;nicos y sociales que precisan los pacientes&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The boundaries between health services levels are artificial as they are answers to health organizations&#8217; problems rather than to patients&#8217; needs&#46; However&#44; given that these boundaries are in place&#44; coordination between these levels should overcome the difficulties so that patients receive the services they require&#46; Case management &#40;patients in specific situations&#44; such as hospital discharge&#41; and disease management &#40;patients with specific diseases&#44; such as diabetes&#41; aim to solve problems of coordination either by improving the organization of health services or by adding a new structure to the already existing structure&#46; These forms of management are highly attractive answers to coordination problems but have no scientific basis nor is there any empirical evidence of a positive impact on patients&#8217; health or the cost of services&#46; Case and disease management programs are vertical structures that weaken the horizontal structure in Spain&#44; i&#46;e&#46; primary care&#46; The need for case and disease management programs is an argument to push for a pro-coordination reform of primary care that gives power&#44; responsibility and autonomy to general practitioners&#44; so that they would be able to coordinate clinical and social services according to patients&#8217; needs&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:33 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Historia de la medicina"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; La&#237;n Entralgo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1994"
                        "editorial" => "Ediciones Cient&#237;ficas T&#233;cnicas"
                        "editorialLocalizacion" => "Barcelona"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is bigger better for primary care groups and truts&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Bjoke"
                            1 => "H&#46; Gravelle"
                            2 => "D&#46; Wilkin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2001"
                        "volumen" => "322"
                        "paginaInicial" => "599"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11238160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Saying goodbye to single-handed practices&#58; what patients and staff lose or gain&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;V&#46;D&#46; Hombergh"
                            1 => "Y&#46; Engels"
                            2 => "H&#46;V&#46;D&#46; Hoogen"
                            3 => "J&#46;V&#46; Doremalen"
                            4 => "W&#46;V&#46;D&#46; Bosch"
                            5 => "R&#46; Grol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/fampra/cmh714"
                      "Revista" => array:6 [
                        "tituloSerie" => "Fam Pract"
                        "fecha" => "2005"
                        "volumen" => "22"
                        "paginaInicial" => "20"
                        "paginaFinal" => "27"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15640293"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practice size and quality attaintment under the new GMS contract&#58; a cross-sectional analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Wang"
                            1 => "C&#46;A&#46; O&#8217;Donnell"
                            2 => "D&#46;F&#46; Mackay"
                            3 => "G&#46;C&#46;M&#46; Watt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Gen Pract"
                        "fecha" => "2006"
                        "volumen" => "56"
                        "paginaInicial" => "830"
                        "paginaFinal" => "835"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17132349"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La coordinaci&#243;n en el sistema sanitario y su mejora a trav&#233;s de las reformas europeas de la atenci&#243;n primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "A&#46; Rico"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SEMERGEN"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "418"
                        "paginaFinal" => "423"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;J&#46; Hunter"
                            1 => "G&#46; Fairfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1997"
                        "volumen" => "315"
                        "paginaInicial" => "50"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9233330"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case management programs in primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;A&#46; Fergurson"
                            1 => "M&#46; Weinberger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Gen Int Med"
                        "fecha" => "1998"
                        "volumen" => "13"
                        "paginaInicial" => "123"
                        "paginaFinal" => "126"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease management&#58; promises and pitfalls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Bodenheimer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199904153401511"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1999"
                        "volumen" => "340"
                        "paginaInicial" => "1202"
                        "paginaFinal" => "1205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10202174"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gesti&#243;n de enfermedades &#40;disease management&#41;&#46; Una aproximaci&#243;n integral a la provisi&#243;n de cuidados sanitarios"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Terol"
                            1 => "E&#46;F&#46; Hamby"
                            2 => "S&#46; Minue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "MEDFAM"
                        "fecha" => "2001"
                        "volumen" => "11"
                        "paginaInicial" => "47"
                        "paginaFinal" => "54"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La gesti&#243;n por procesos asistenciales integrales&#58; una estrategia necesaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Torres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2003"
                        "volumen" => "31"
                        "paginaInicial" => "561"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12783744"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La gesti&#243;n de casos &#40;y de enfermedades&#41;&#44; una organizaci&#243;n vertical de los servicios sanitarios"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SEMERGEN"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "370"
                        "paginaFinal" => "374"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n de intervenciones en atenci&#243;n primaria para mejorar el control de las enfermedades cr&#243;nicas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Sancho"
                            1 => "A&#46; Sarri&#225;"
                            2 => "D&#46; Y&#225;&#241;ez"
                            3 => "A&#46; Hern&#225;ndez"
                            4 => "M&#46;A&#46; Ovalie"
                            5 => "A&#46; Perianes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2003"
                        "editorial" => "AETS&#44; Instituto de Salud Carlos III&#44; Ministerio de Sanidad"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Hutt R&#44; Rosen R&#44; McCauley J&#46; Case-management long term conditions&#46; What impact does it have in the treatment of older people&#63; London&#58; The King&#39;s Fund&#59; 2004&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.kingsfund.org.uk/pdf/casemanagement.pdf">www&#46;kingsfund&#46;org&#46;uk&#47;pdf&#47;casemanagement&#46;pdf</a>"
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Experiencias de integraci&#243;n cl&#237;nica&#46; El equilibrio entre gesti&#243;n de casos y gesti&#243;n de enfermedades cuando solo existen enfermos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Meneu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Integraci&#243;n asistencial&#58; fundamentos&#44; experiencias y v&#237;as de avance"
                        "serieFecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "De la gesti&#243;n de lo complementario a la gesti&#243;n integral de la atenci&#243;n de salud&#58; gesti&#243;n de enfermedades e indicadores de actividad"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Peir&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Gesti&#243;n cl&#237;nica y sanitaria"
                        "paginaInicial" => "17"
                        "paginaFinal" => "87"
                        "serieFecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fundamentos y eficiencia de la atenci&#243;n m&#233;dica primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Ort&#250;n"
                            1 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1996"
                        "volumen" => "106"
                        "paginaInicial" => "97"
                        "paginaFinal" => "102"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atenci&#243;n primaria fuerte&#58; fundamento cl&#237;nico&#44; epidemiol&#243;gico y social en los pa&#237;ses desarrollados y en desarrollo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "M&#46; P&#233;rez Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Epidemiol"
                        "fecha" => "2006"
                        "volumen" => "9"
                        "paginaInicial" => "384"
                        "paginaFinal" => "400"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Moderaci&#243;n de la actividad m&#233;dica preventiva y curativa&#46; Cuatro ejemplos de necesidad de prevenci&#243;n cuaternaria en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "numero" => "Supl 1"
                        "paginaInicial" => "127"
                        "paginaFinal" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16539975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergency admission for cancer&#58; a matter of survival&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Porta"
                            1 => "E&#46; Fern&#225;ndez"
                            2 => "J&#46; Belloc"
                            3 => "N&#46; Malats"
                            4 => "M&#46; Gallen"
                            5 => "J&#46; Alonso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Cancer"
                        "fecha" => "1998"
                        "volumen" => "77"
                        "paginaInicial" => "477"
                        "paginaFinal" => "484"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9472647"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#191;C&#243;mo mejorar la atenci&#243;n a las enfermedades cr&#243;nicas&#63; Una ilustraci&#243;n en pacientes con insuficiencia card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Rodr&#237;guez Artalejo"
                            1 => "J&#46;R&#46; Banegas"
                            2 => "M&#46; Conde"
                            3 => "R&#46; Hern&#225;ndez"
                            4 => "C&#46; Rodr&#237;guez"
                            5 => "M&#46;T&#46; Olcoz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Gesti&#243;n cl&#237;nica y sanitaria"
                        "paginaInicial" => "1"
                        "paginaFinal" => "15"
                        "serieFecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2005&#46; Innovaci&#243;n en la Uni&#243;n Europea &#40;UE-15&#41; sobre la coordinaci&#243;n entre atenci&#243;n primaria y especializada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "A&#46; Rico"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "126"
                        "paginaInicial" => "658"
                        "paginaFinal" => "661"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2006&#46; Capacidad de respuesta de la atenci&#243;n primaria y redes de servicio&#46; El caso del Consorci Hospitalari de Catalunya"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; G&#233;rvas"
                            1 => "O&#46; Pan&#233;"
                            2 => "A&#46; Sicras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2006"
                        "volumen" => "38"
                        "paginaInicial" => "506"
                        "paginaFinal" => "510"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17194355"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Blendon RJ&#44; DesRoches CM&#44; Fleischfresser C&#44; Benson JM&#44; Weldon K&#44; Jovell AJ&#44; et al&#46; Confianza en el Sistema Nacional de Salud&#46; Resultados del estudio espa&#241;ol&#46; Barcelona&#58; Harvard School of Public Health y Fundaci&#243; Biblioteca Josep Laporte&#59; 2006&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.fbjoseplaporte.org/docs/trust_spanish_hcs.pdf">www&#46;fbjoseplaporte&#46;org&#47;docs&#47;trust&#95;spanish&#95;hcs&#46;pdf</a>"
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Jovell AJ&#46; El futuro de la profesi&#243;n m&#233;dica&#46; An&#225;lisis del cambio social y los roles de la profesi&#243;n m&#233;dica en el siglo XXI&#46; Barcelona&#58; Fundaci&#243; Biblioteca Josep Laporte&#59; 2001&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.fbjoseplaporte.org/docs/futuropm.pdf">www&#46;fbjoseplaporte&#46;org&#47;docs&#47;futuropm&#46;pdf</a>"
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#191;A qu&#233; incentivos responde la utilizaci&#243;n hospitalaria en el Sistema Nacional de Salud&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Peir&#243;"
                            1 => "E&#46; Bernal Delgado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "numero" => "Supl 1"
                        "paginaInicial" => "110"
                        "paginaFinal" => "116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16539973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La coordinaci&#243;n entre atenci&#243;n primaria y especializada&#58; &#191;reforma del sistema sanitario o reforma del ejercicio profesional&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Ojeda"
                            1 => "J&#46;M&#46; Freire"
                            2 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Adm Sanit"
                        "fecha" => "2006"
                        "volumen" => "4"
                        "paginaInicial" => "357"
                        "paginaFinal" => "382"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La coordinaci&#243;n entre niveles asistenciales&#58; una sistematizaci&#243;n de sus instrumentos y medidas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Terraza"
                            1 => "I&#46; Vargas"
                            2 => "M&#46;L&#46; V&#225;zquez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "485"
                        "paginaFinal" => "495"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17198628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease management&#58; panacea&#44; another false hope or something in between&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;P&#46; Gem&#237;an"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1370/afm.649"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Fam Med"
                        "fecha" => "2007"
                        "volumen" => "5"
                        "paginaInicial" => "257"
                        "paginaFinal" => "260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17548854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Can disease management target patients most likely to generate high costs&#63; The impact of comorbidity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Charlson"
                            1 => "R&#46;E&#46; Charlson"
                            2 => "W&#46; Briggs"
                            3 => "J&#46; Hollemberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11606-007-0130-7"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Gen Intern Med"
                        "fecha" => "2007"
                        "volumen" => "22"
                        "paginaInicial" => "464"
                        "paginaFinal" => "469"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17372794"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673610613815"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluaci&#243;n de una intervenci&#243;n domiciliaria en pacientes con insuficiencia card&#237;aca&#46; Resultados de un estudio aleatorizado"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Morcillo"
                            1 => "J&#46;M&#46; Valderas"
                            2 => "O&#46; Aguado"
                            3 => "J&#46; Del&#225;s"
                            4 => "D&#46; Sort"
                            5 => "R&#46; Pujades"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "2005"
                        "volumen" => "58"
                        "paginaInicial" => "618"
                        "paginaFinal" => "625"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15970116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ensayo cl&#237;nico aleatorizado para reducir hospitalizaciones y mejorar la calidad de vida de los pacientes con insuficiencia card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Brot&#243;ns"
                            1 => "M&#46; Mart&#237;nez"
                            2 => "E&#46; Ray&#237;"
                            3 => "C&#46; Morralla"
                            4 => "E&#46; Ballar&#237;n"
                            5 => "E&#46; P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2005"
                        "volumen" => "36"
                        "paginaInicial" => "280"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16194498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2005&#46; Sustituci&#243;n de la primaria por la especializada&#46; Algunas cuestiones en torno al seguimiento de los pacientes con insuficiencia card&#237;aca"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SEMERGEN"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "125"
                        "paginaFinal" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seminario Innovaci&#243;n 2005&#46; Potenciar la atenci&#243;n primaria para mejorar el seguimiento de la insuficiencia card&#237;aca en los pa&#237;ses desarrollados"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; G&#233;rvas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "457"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16756846"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760886/v1_201301221349/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "713"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cap&#237;tulo 4&#46; Un sistema de salud integrado y centrado en los usuarios"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02139111/00000022000000S1/v1_201301221349/S0213911108760886/v1_201301221349/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760886?idApp=WGSE"
]
Información del artículo
ISSN: 02139111
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 10 2 12
2024 Octubre 67 45 112
2024 Septiembre 54 25 79
2024 Agosto 76 33 109
2024 Julio 52 27 79
2024 Junio 43 20 63
2024 Mayo 48 24 72
2024 Abril 45 21 66
2024 Marzo 41 21 62
2024 Febrero 39 31 70
2024 Enero 25 23 48
2023 Diciembre 29 18 47
2023 Noviembre 45 25 70
2023 Octubre 32 22 54
2023 Septiembre 37 20 57
2023 Agosto 36 21 57
2023 Julio 36 24 60
2023 Junio 38 12 50
2023 Mayo 28 11 39
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Gaceta Sanitaria
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?