Access of patients with breast and lung cancer to chemotherapy treatment in public and private hospitals in the city of Buenos Aires

Abstract

Objectives Describe the time elapsed from the diagnosis to treatment with chemotherapy for patients with breast and lung cancer at public and private hospitals in Buenos Aires. Design Retrospective cohort study. Setting Three public and three private academic hospitals in Buenos Aires. Participants Patients with breast (n = 168) or lung cancer (n = 100) diagnosis treated with chemotherapy. Main outcomes measures Clinical and sociodemographic data were collected in a stratified sample. We used the Kaplan–Meier estimator to analyse the time elapsed and the log rank test to compare both groups Results For breast cancer patients, median time elapsed between diagnosis and treatment with chemotherapy was 76 days (95% CI: 64–86) in public and 60 days (95% CI: 52–65) in private hospitals (P = 0.0001). For adjuvant and neoadjuvant treatments, median time was 130 (95% CI: 109–159) versus 64 (95% CI: 56–73) days (P < 0.0001) and 57 days (95% CI: 49–75) versus 26 (95% CI: 16–41) days, respectively (P = 0.0002). There were no significant differences in the time from first consultation to diagnosis. In patients with lung cancer, median time from diagnosis to treatment was 71 days (95% CI: 60–83) in public hospitals and 31 days (95% CI: 24–39) in private hospitals (P = 0.0002). In the metastatic setting, median time to treatment was 63 days (95% CI: 45–83) in public and 33 (95% CI: 26–44) days in private hospitals (P = 0.005). Conclusions There are significant disparity in the access to treatment with chemotherapy for patients in Buenos Aires, Argentina.

Health seeking behaviours and private sector delivery of care for non-communicable diseases in low- and middle-income countries: a systematic review

“…A common theme was the private sector performing better on process quality for resource-intensive interventions such as those requiring more health worker time, specialised expertise, costly medications, or diagnostics. Such examples included thrombolysis for stroke patients, [ 70 ] interventions for acute coronary syndrome (ACS), post-ACS management, [ 76 , 113 , 114 ] and cancer treatment, [ 69 , 107 , 115 , 116 ] and routine screening for diabetes complications [ 117 ]. Two studies also reported that patients in the private sector had access to new or expensive medications for cancer treatment [ 118 , 119 ].…”

“…Two studies also reported that patients in the private sector had access to new or expensive medications for cancer treatment [ 118 , 119 ]. When it came to less complex and less resource intensive interventions, a number of studies [ 68 , 69 , 111 ] found that public sector facilities were able to perform as well or better than the private sector.…”

Geographic and sociodemographic access to systemic anticancer therapies for secondary breast cancer: a systematic review

“…Treatment receipt was reported for different types of SACT which included chemotherapy, immunotherapy, targeted therapy which included cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i), unspecified SACT and endocrine therapy. Seven studies reported chemotherapy where overall receipt ranged from 22 to 60% [ 29 , 30 , 35 , 37 , 38 , 41 , 43 ]. Receipt of endocrine therapy was reported in one study which evaluated factors associated with treatment receipt among women with hormone receptor-positive disease where overall treatment receipt was reported as 70.8% [ 45 ].…”

“…Four studies reported time to treatment [ 34 , 39 – 41 ]. These included two studies which reported time to treatment with non-specified SACT chemotherapy and immunotherapy [ 39 , 40 ].…”

“…Patient delay time was reported as 4.8 weeks with a total delay time of 13.8 weeks [ 40 ]. Eighty-one percent of patients received treatment within 60 days [ 39 ], and treatment delay differences between public and private hospitals were reported as 76 days (64–86) < 0.0001 and 60 days (52–65) < 0.0001 respectively [ 41 ] (Table 4 ).…”