Shorter delay to treatment by integrated diagnostic services and NGO- provided support among breast cancer patients in two Brazilian referral centres
| Autor: | Tácila Thamires de Melo Santos, Milena Edite Case de Oliveira, Lorena Sofia dos Santos Andrade, Kedma Anne Lima Gomes, Tiago Almeida de Oliveira, Mathias Weller, Adriana Raquel Araújo Pereira Soares |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Referral public and private diagnostic services patient flow Developing country Article Outsourcing 03 medical and health sciences 0302 clinical medicine Breast cancer treatment delay Medicine 030212 general & internal medicine business.industry Proportional hazards model Public health Incidence (epidemiology) lcsh:Public aspects of medicine lcsh:RA1-1270 medicine.disease 030220 oncology & carcinogenesis Family medicine Diagnostic Mammography business outsourced diagnostic services |
| Zdroj: | Journal of Public Health Research (2021) Journal of Public Health Research |
| Popis: | Background: The diagnosis of breast cancer requires a complicated series of diagnostic exams. The present study addressed the delay of patients who used publicly and privately financed diagnostic services. Non-governmental organizations (NGOs) donated diagnostic mammograms and biopsies. Design and Methods: Data from 304 patients were obtained from two Brazilian referral centres. In one referral centre (FAP), diagnostic mammography, clinic-histopathological exam and immunohistochemistry were outsourced, whereas in the other centre (HNL), these services were integrated. Cox regression, Kaplan-Meier analysis and non-parametric tests were used to compare variables and time intervals. Results: If diagnostic mammography was financed privately and covered by private health insurance, the likelihood of a delay of >90 days between the first medical visit and the initiation of treatment decreased 2.15-fold (95%CI: 1.06-4.36; p=0.033) and 4.44-fold (95%CI: 1.58-12.46; p=0.004), respectively. If the clinic- histopathological exam was outsourced (FAP) and publicly or privately financed, the median time between diagnostic mammography and the diagnostic result was 53 and 65 days in the integrated (HNL) and outsourced public system, compared to 29 days in the outsourced private system (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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