scholarly journals Delayed Access to Medical Care of Patients with Breast Cancer

2018 ◽  
Vol 6 (11) ◽  
Author(s):  
Kenia Yazmín García Perusquía ◽  
Juan Carlos Paz Bautista
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Developing Countries ◽  
Medical Care ◽  
Access To Health Care ◽  
Public Policies ◽  
Clinical Stage ◽  
Public Health Problem ◽  
Diagnosis And Treatment ◽  
Timely Diagnosis

Breast cancer is a public health problem and it is more frequent in women living in both developed and developing countries, so it is important to identify the factors associated with delayed access to health care and to implement public policies for a timely diagnosis and treatment. The objective of this review is to collect existing information on breast cancer, its definition, classification, and to identify socio-structural factors of health care services that are associated with delayed medical care that negatively affects in clinical nationalization and therefore a 5-year survival, besides the need for further research related to this topic. Timely diagnosis and therapy for patients with breast cancer require the modification and implementation of current public policies in order to contribute to the reduction of mortality, especially in developing countries, since it has not only an economic impact but also a personal, social and family impact. Late diagnosis and treatment of breast cancer have been associated with a reduced survival period due to the clinical stage of the diagnosis in which a delay of more than three months was identified related to delays in the patient and not only by the lack of identification of signs and symptoms, but also by the lack of human resources and infrastructure.

scholarly journals Female Breast Cancer in Suriname: Pathways to Treatment—A Patient’s Perception

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Euridice R. Irving ◽  
Dennis R. A. Mans ◽  
Els Th. M. Dams ◽  
Maureen Y. Lichtveld
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Access To Health Care ◽  
Early Stage ◽  
Diagnosis And Treatment ◽  
Related Factors ◽  
Entire Interval ◽  
Early Stage Disease ◽  
Resource Setting ◽  
Stage Disease

PURPOSE Delays across the entire cancer care continuum are not uncommon. This cross-sectional study explored the health care trajectories of Surinamese women with breast cancer and identified predictors of timely diagnosis and treatment initiation. METHODS One hundred women age 30 years or older who were newly diagnosed with breast cancer in 2017 to 2018 were recruited from all 4 hospitals in Paramaribo. Data on their demographics, lifestyle, reproductive and medical history, health status, and family history of breast cancer and other malignancies were collected using a validated semistructured questionnaire. Using Anderson’s Model of Pathways to Treatment, we defined a patient interval (from detection to first consultation), diagnostic interval (from consultation to histopathologic diagnosis), and treatment interval (from diagnosis to first treatment). Log-transformed data were analyzed using linear regression, and variables with P ≤ .05 were considered statistically significant predictors of intervals. RESULTS All participants had health insurance and access to health care. Eighty-five percent of patients presented with early-stage disease. Ninety percent of patients had self-detected their disease, with 70% finding a lump. Average age was 55.6 years (± 11.8 years). Median durations of patient, diagnostic, and treatment intervals were 13 days (interquartile, range, 4-63 days), 40 days (IQR, 21-57 days), and 18 days (IQR, 8-38 days), respectively. Median duration of the entire interval was 95 days (IQR, 59-272 days). Patient-related factors associated with the intervals were religion (β = −530; P = .003), being employed (β = 149.4; P = .007), and age 50 years and older (β = −195.8; P = .037). Disease-related factors were lump as first symptom (β = −175.6; P = .038) and late-stage disease at diagnosis (β = 213.5; P = .004). CONCLUSION Given the limited-resource setting, delays in Suriname’s health care can be minimized by programs aimed at increasing breast cancer awareness and education; however, delays may have been underestimated as a result of the over-representation of early-stage disease and recall bias regarding the first symptom detected.

Breast Cancer in Latin America: A Map of the Disease in the Region

2018 ◽  
pp. 451-456 ◽  
Author(s):  
Eduardo Cazap
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Latin America ◽  
Urban Areas ◽  
Access To Health Care ◽  
Cancer Control ◽  
Public Health Problem ◽  
The United States ◽  
High Morbidity ◽  
Patient Organizations

In the next few decades, breast cancer will become a leading global public health problem as it increases disproportionately in low- and middle-income countries. Disparities are clear when comparisons are made with rates in Europe and the United States, but they also exist between the countries of the region or even within the same country in Latin America. Large cities or urban areas have better access and resource availability than small towns or remote zones. This article presents the status of the disease across 12 years with data obtained through three studies performed in 2006, 2010, and 2013 and based on surveys, reviews of literature, patient organizations, and public databases. The first study provided a general picture of breast cancer control in the region (Latin America); the second compared expert perceptions with medical care standards; and the third was a review of literature and public databases together with surveys of breast cancer experts and patient organizations. We conclude that breast cancer is the most frequent cancer and kills more women than any other cancer; we also suggest that aging is the principal risk factor, which will drive the incidence to epidemic levels as a result of demographic transition in Latin America. The economic burden also is large and can be clearly observed: in countries that today allocate insufficient resources, women go undiagnosed or uncared for or receive treatment with suboptimal therapies, all of which results in high morbidity and the associated societal costs. The vast inequities in access to health care in countries translates into unequal results in outcomes. National cancer control plans are the fundamental building block to an organized governance, financing, and delivery of health care for breast cancer.

scholarly journals Changing goals in the management of breast carcinoma patients towards preservation of feminity and quality of life

2018 ◽  
Vol 4 (2) ◽  
pp. 96-98
Author(s):  
Soumi Pathak ◽  
Ajay Kumar Bhargava
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Health Care ◽  
Developing Countries ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Health Care Burden

Breast cancer is the commonest cancer in women worldwide. In the developing countries of Asia, the health care burden on account of breast cancer has been steadily mounting. Over 100,000 new breast cancer patients are estimated to be diagnosed annually in India.1 As per the ICMR-PBCR data, breast cancer is the commonest cancer among women in urban registries of Delhi, Mumbai, Ahmedabad, Calcutta, and Trivandrum where it constitutes > 30% of all cancers in females. Previous literature on mastectomy indicates that the operation may be perceived by the patient as a threat to her feminity. Breast cancer survivors have dissatisfaction with appearance, perceived loss of femininity and body integrity, self-consciousness about appearance, and dissatisfaction with surgical scars… Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 96-98 

Digital Divide and E-Health Implications for E-Collaboration Research

2011 ◽  
pp. 1574-1580
Author(s):  
Michele Masucci
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Information And Communication Technologies ◽  
Access To Health Care ◽  
Care Delivery ◽  
Communication Technologies ◽  
Collaborative Tools ◽  
Specialized Care ◽  
Health Care Delivery Systems ◽  
Health Applications

E-health has rapidly gained attention as a framework for understanding the relationship between using information and communication technologies (ICTs) to promote individual and community health, and using ICTs for improving the management of health care delivery systems. The use of e-collaborative tools is implicit to the delivery and access of e-health. Development of the capacity to transmit and receive digital diagnostic images, use video telecommunications for supporting the remote delivery of specialized care and surgical procedures, and the use of e-communication technologies to support logistical elements of medical care (such as scheduling appointments, filling prescriptions, and responding to patient questions) are just a few ways in which e-communications are transforming how medical care is embedded within institutional, organizational, family, and community settings. The emerging field of e-collaboration focuses attention on the need for society to critically examine how electronic communication technologies facilitate, shape, and transform the ways in which organizations, groups, and communities interact. There are many works that explain how to (a) develop e-health systems, (b) assess the use of such systems, and (c) analyze the health outcomes that can be achieved with effective e-health applications (Brodie et al., 2000; Eder, 2000; Spil & Schuring, 2006). Less attention has been paid to how advances in e-collaboration research might inform e-health applications development and scholarly discourse. Because of this gap in the literature, few discussions pertain to understanding patient perspectives about the advantages and disadvantages that may result from rapidly emerging interconnections among access to health care, health information, health support systems, and ICTs (Berland et al., 2001; Hesse et al., 2005; Gibbons, 2005; Gilbert & Masucci, 2006).

scholarly journals Awareness on Cancer and Barriers to Health Care Seeking Among Adults of Bardiya

2020 ◽  
Vol 8 (1) ◽  
pp. 47-50
Author(s):  
Chanda Sah ◽  
Srijana Aryal ◽  
Gita Neupane
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Public Health Problem ◽  
Structured Interview ◽  
Warning Signs ◽  
Diagnosis And Treatment ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Cancer Awareness ◽  
Awareness Campaigns

INTRODUCTION: Cancer is a leading public health problem worldwide. Low awareness on cancer leads to increase in burden of cancer diagnosis and treatment. MATERIAL AND METHODS: Descriptive cross-sectional study was conducted to find out awareness regarding cancer among people. Total 100 samples were selected by using non-probability purposive sampling method. Semi-structured interview schedule was developed with the guide of the Cancer Awareness Measure (CAM) to collect data. Collected data were analysed by using descriptive and inferential statistics. RESULTS: The findings of the study showed that none of the study respondents were aware of all the nine warning signs of cancer. Majority (80%) of the respondents were aware that “a sore that doesn’t heal” and minority (15%) knew about “change in bowel and bladder habit” as warning signs of cancer. Regarding risk factors, majority knew chemical fertilizer and pesticides and unseasonal fruits and vegetables (90%), smoking (88%) as risk factors of cancer and minority (32%) knew about excessive sun exposure. There was statistically significant association between respondents’ level of awareness regarding cancer with education status (p= 0.011). CONCLUSION: Findings of the study revealed that more than half (68%) of the adults had low awareness regarding cancer. Emotional barriers (88%) were known to be affecting health care seeking behaviours for cancer. Therefore, it is recommended to organize health awareness campaigns addressing emotional barriers might improve in early diagnosis and treatment of cancer.

scholarly journals Public Policies and patents for breast cancer in Brazil, India and Australia

2018 ◽  
Vol 6 (10) ◽  
pp. 287-298
Author(s):  
Áurea Machado de Aragão ◽  
Antônio Martins De Oliveira Júnior
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Public Policies ◽  
Public Health Problem ◽  
Access To Medicines ◽  
Self Awareness ◽  
Cancer Breast ◽  
Incidence And Mortality ◽  
Breast Breast Cancer ◽  
Research Investments

This article illustrates that public policies to facilitate access to medicines, research investments, and self-awareness for breast cancer are the way to change the scenario of breast cancer in Brazil, India and Australia. The motivation was due to the fact that the literature reports breast cancer as a public health problem due to high incidence and mortality rates, whether the country is developed or not. The method adopted was the review study based on the data analysis on public policies and patents for breast cancer in Brazil, India and Australia available in official websites, INPI, Espacenet and Patentscope databases, journals and international newspapers Specialized and physical literature related to the theme. The descriptors used were cancer, breast, breast cancer, breast cancer and Australia, cancer patents, breast cancer and India. The following inclusion criteria used were year and period of publication, availability of the article in full and the intersection between the descriptors. The research concluded that there is an urgent need to prioritize public health with more investment in breast cancer research and awareness programs on the importance of early detection in those countries, primarily in India.

scholarly journals IMPACT OF RESOURCE MANAGEMENT QUALITY ON ACCESS TO HEALTH CARE

2020 ◽  
Vol 15 (3) ◽  
pp. 88-93
Author(s):  
Sergey Budarin ◽  
Yuliya El'bek
Keyword(s):  
Health Care ◽  
Resource Management ◽  
Health System ◽  
Medical Care ◽  
Rural Areas ◽  
Financial Management ◽  
Access To Health Care ◽  
Importance Value ◽  
Management Quality

The potential for improving the efficiency of medical organizations that provide medical care to the population in conditions of limited resources largely depends on an objective and comprehensive assessment of their use. In this regard, the research of methodological and practical approaches to assessing the efficiency and rational use of resource potential, which are important for different levels of the organization of the health system, including the provision of medical care to citizens living in rural areas, is of particular relevance. The purpose of the study was to determine the relationship between indicators for assessing the quality of resource management and indicators of access to medical care of medical organizations of the state health system in Moscow that provide primary health care to adults in 2019. The quality of resource management was assessed using 27 indicators selected for the purpose of the study in 4 areas of resource management (financial management, procurement management, property management, personnel management), provided by the methodology of the resource management quality standard (RMQS). For each indicator, the calculated score based on the importance value (weight value) a normative criterion of evaluation and the degree of difficulty, and by summing up of scores obtained a composite score. The assessment of the availability of medical care is also calculated using the method of point estimates based on 7 indicators developed through the use of the methodology of performance audit. The article presents the results of a study based on data from 9 Moscow city polyclinics, which confirmed the existence of a correlation between the selected indicators of the quality of resource management and the availability of medical care. The total score for 2019 for the selected indicators of resource management quality varies from 9.62 points to 13.92 points, availability-from 5.54 to 11.63 points, and the correlation coefficient was 0.612

Comparison of neoadjuvant anti-HER2 therapy for breast cancer in public versus private health care: Time to shorten the distance.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18045-e18045
Author(s):  
Virginia Braga ◽  
Jessica Ribeiro Gomes ◽  
Noelle Suemi Wassano ◽  
Jessica Sayuri Tsukamoto ◽  
Luiza Damian Ribeiro Barbosa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Clinical Stage ◽  
Locally Advanced ◽  
Surrogate Marker ◽  
Complete Response ◽  
Public Health Care ◽  
Cancer Center ◽  
Her2 Positive ◽  
Metastatic Setting

e18045 Background: In the neoadjuvant setting (NAC) of HER2-positive breast cancer (BC), the addition of pertuzumab (P) to trastuzumab (T) and chemotherapy (chemo) has increased pathological complete response (pCR) from 40-50% to over 70%. Recent data has shown that pCR is a reliable surrogate marker of disease-free (DFS) and overall survival (OS). In Brazil, there is an important gap between cancer drugs approved in the public health care system (PHCS) vs. the private setting. Although P approval for NAC (Aug/2016) and metastatic setting (Sep/2015) in the private health system, it is not approved for any indication in the PHCS. Likewise, T is not approved for use as NAC at the PHCS. We aim to compare private practice experience of T + P + chemo in the NAC vs. HER2-positive advanced BC patients treated at the PHCS. Methods: Retrospective analysis of 95 patients diagnosed with locally advanced HER2-positive BC by immunohistochemistry 3+ or FISH according to ASCO/CAP definition. We evaluated 17 consecutive patients at the COAEM private cancer center in Brazil since Feb/2014 (cohort 1). Neoadjuvant therapy was T and P plus docetaxel-based chemo. A cohort of 78 patients with locally advanced HER2-positive BC treated in a PHCS cancer center was analyzed (cohort 2). They received standard NAC regimen according to PHCS guidance: anthracycline and taxane-based therapy without anti-HER2 therapy. Results: Cohort 1: 17 patients with median age of 50 years (range 34-70); Four patients had clinical stage IIA; 2 patients IIB; 7 patients IIIA; 3 patients IIIB; one patient IIIC. The pCR rate was 70.5% (12 patients). Cohort 2: 78 patients with median age of 48 years (range 26-79). One patient IIB; 33 patients IIIA; 37 patients IIIB; 7 patients IIIC. The pCR rate was 16.7% (13 patients); 29 patients (37.2%) had clinical complete response. Only 26 patients (33.3%) received T in the adjuvant setting. Conclusions: Neoadjuvant P and T combined with chemo has shown pCR rates superior to 70% in clinical trials, which is a surrogate marker for DFS and OS in HER2-positive BC. The absence of anti-HER2 therapy in the PHCS must be urgently reviewed not just in light of double-blockage strategy but also in T monotherapy use.

THE ASSOCIATION BETWEEN FAMILY STRUCTURE, REPORTS OF ILLNESS AND HEALTH CARE DEMAND FOR CHILDREN: EVIDENCE FROM RURAL BANGLADESH

2009 ◽  
Vol 41 (5) ◽  
pp. 645-659 ◽  
Author(s):  
ATONU RABBANI ◽  
G. CALEB ALEXANDER
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Parental Education ◽  
Maternal Education ◽  
Household Head ◽  
Developed Countries ◽  
Health Care Demand ◽  
Rural Bangladesh

SummaryAccess to health care in lesser-developed countries is often quite limited, especially in rural areas. However, less is known about how different factors, such as household structure, parental income and parental education, modify such access to care. This study uses individual-level data from rural Bangladesh during and following a period of major flooding to examine factors associated with reports of illness and demand for doctors in households with children less than 10 years of age. Using information about the number of children who were reported sick and also those who were taken to a doctor, a model was estimated for such reports and decisions to visit a doctor. Overall, 74% of households reported an illness in a child during the study period. The likelihood of reports was significantly greater for boys (36%) than girls (31%). In most analyses, there was no association between parental education and reports of child illness after adjusting for village- and household-level heterogeneity. However, in analyses limited to female children, greater education of the household head was associated with lower odds of such a report (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.91–1.00). Parental education and income were also related to household decisions to seek medical care, though results once again differed based on the sex of the child. There was a particularly strong effect between maternal education level and demand for medical care for boys (OR 1.13; CI 1.01–1.27), though not for girls (OR 0.96; CI 0.84–1.09). Overall, the likelihood of a doctor's visit for a sick child was positively related to household income and at the highest levels of income was a virtual certainty.

scholarly journals Barriers in health care to breast cancer: perception of women

2014 ◽  
Vol 48 (3) ◽  
pp. 394-400 ◽  
Author(s):  
Leila Luiza Conceição Gonçalves ◽  
Gabriela Lima Travassos ◽  
Ana Maria de Almeida ◽  
Alzira Maria D’Ávila Nery Guimarães ◽  
Cristiane Franca Lisboa Gois
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Access To Health Care ◽  
Health Policies ◽  
Public Health Policies ◽  
The Public ◽  
Access To Health ◽  
Semistructured Interviews ◽  
Policies And Programs ◽  
Trajectory Of Care

Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy.Method: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17.Results: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer.Conclusion: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.



Sign in / Sign up

Export Citation Format

Share Document