Shorter delay to treatment by integrated diagnostic services and NGO- provided support among breast cancer patients in two Brazilian referral centres

Autor: Lorena Sofia dos Santos Andrade, Tácila Thamires de Melo Santos, Milena Edite Case de Oliveira, Kedma Anne Lima Gomes, Adriana Raquel Araújo Pereira Soares, Tiago Almeida de Oliveira, Mathias Weller
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Public Health Research (2021)
Druh dokumentu: article
ISSN: 2279-9028
2279-9036
DOI: 10.4081/jphr.2021.1880
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
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