Elapsed time from breast cancer detection to first adjuvant therapy in a Canadian province, 1999-2000

Improving Patient Flow and Timeliness in the Diagnosis and Management of Breast Abnormalities: The Impact of a Rapid Diagnostic Unit

“…In an era of limited health care resources, issues with wait times have populated the literature, particularly with respect to surgical procedures for cancer treatment [7][8][9][10][11] . In Canada, health care is delivered though a universal system in which administration and funding are handled jointly at the federal and provincial levels.…”

Inequity in access to cancer care: a review of the Canadian literature

“…First, researchers studying inequity in cancer care should strive to provide a richer description of inequity in access to services along the continuum of care, either by examining, within single studies, multiple points of service or by periodically conducting reviews like this study. Understanding inequities at multiple points of the care trajectory is important since access to each point of care is dependent on the preceding points and inequities appear to vary along the cancer care continuum [19][20][21][22][23][24][25][26][27][28][29][30][31][32]. For example, Saint Jacques et al, examining inequities in wait times for breast cancer services in Nova Scotia from detection of disease to initiation of adjuvant therapy, identified that having a higher education was significantly associated with shorter wait times from detection to referral, but not associated with wait times from referral to first adjuvant therapy [19].…”

“…Age was examined by 34 of the 51 studies included in the review. Older patients are reported to have less access to medical and radiation oncology consultations, adjuvant and palliative radiotherapy and to palliative care programs, even after controlling for need [3,4,15,[25][26][27].…”

Diagnostic errors in ambulatory care: dimensions and preventive strategies

“…Diagnoses are made in time-pressured primary care visits, where providers are often unaware of the ultimate patient outcome. Consequently, outpatient diagnostic errors may be more common than realized and result from many types of process-of-care breakdowns (Rayson et al 2004; Wahls and Cram 2007; Langenbach et al 2003; Aiello Bowles et al 2008; Gandhi et al 2006; Singh et al 2007b). In addition, diagnostic errors are hard to identify, it is challenging to ascertain their real causes, and they are difficult to prevent.…”