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Availability of Diagnostic Services and their Impact on Patient Flow in Two Brazilian Referral Centres of Breast Cancer Treatment.
de Melo Santos, Tácila Thamires; Dos Santos Andrade, Lorena Sofia; Case de Oliveira, Milena Edite; Lima Gomes, Kedma Anne; Almeida de Oliveira, Tiago; Weller, Mathias.
Afiliação
  • de Melo Santos TT; Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande- Paraíba, Brazil.
  • Dos Santos Andrade LS; Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande- Paraíba, Brazil.
  • Case de Oliveira ME; Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande- Paraíba, Brazil.
  • Lima Gomes KA; Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande- Paraíba, Brazil.
  • Almeida de Oliveira T; Department of Statistics, State University of Paraíba (UEPB), Campina Grande- Paraíba, Brazil.
  • Weller M; Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande- Paraíba, Brazil.
Asian Pac J Cancer Prev ; 21(2): 317-324, 2020 Feb 01.
Article em En | MEDLINE | ID: mdl-32102505
BACKGROUND: System delay (SD) is a leading cause of advanced stage of disease and poor prognosis among Brazilian breast cancer patients. METHODS: Cox regression and Kaplan-Meier analysis were used to identify variables that contributed to SD among 128 breast cancer patients. Time intervals between first medical consultation and treatment initiation were compared among patients of two referral centres: Patients of a referral centre with outsourced (FAP), respectively, integrated (HNL) diagnostic services. RESULTS: Women who used a specialized private clinic at the beginning of patient flow had an 2.32 fold increased chance (95% CI: 1.17 - 4.60; p = 0.016) of hospital admission within 90 days after first medical consultation, compared to women who used a public health care provider (HCP). Of 73 and 34 patients of the FAP hospital and the HNL, respectively, 10 (13.7%) and 11 (32.5%) used one HCP prior to hospital admission (p = 0.000). The median time between first medical consultation and treatment initiation was 150 days. The median time between first medical consultation and hospital admission was 136.0 and 52.0 days for patients of the FAP hospital, respectively the HNL (p < 0.050). The median time between first medical consultation and diagnostic mammography was 36.5 and 23.0 days for patients from the FAP hospital and the HNL (p < 0.050). CONCLUSIONS: Usage of public diagnostic services was associated with increased SD, whereas the usage of private diagnostic services diminished it. The usage of a lower number of HCPs accelerated patient flow.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Neoplasias da Mama / Eficiência Organizacional / Prestação Integrada de Cuidados de Saúde / Serviços de Diagnóstico / Diagnóstico Tardio / Acessibilidade aos Serviços de Saúde Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Female / Humans / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Asian Pac J Cancer Prev Assunto da revista: NEOPLASIAS Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Tailândia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Neoplasias da Mama / Eficiência Organizacional / Prestação Integrada de Cuidados de Saúde / Serviços de Diagnóstico / Diagnóstico Tardio / Acessibilidade aos Serviços de Saúde Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Female / Humans / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Asian Pac J Cancer Prev Assunto da revista: NEOPLASIAS Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Tailândia