Healthcare Delay in Breast Cancer Patients: A Case Study in a Low-Density Population Region from Mexico

Rangel-Méndez, Jorge Aarón; Novelo-Tec, José Feliciano; Sánchez-Cruz, Juan Francisco; Cedillo‐Rivera, Roberto; Moo-Puc, Rosa

doi:10.2217/fon-2017-0713

Cited by 2 publications

(5 citation statements)

References 22 publications

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“…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 ].…”

Section: Resultsmentioning

confidence: 99%

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

Brindley,

Wijemunige,

Dieteren

et al. 2024

BMC Health Serv Res

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Background Globally, non-communicable diseases (NCDs) are the leading cause of mortality and morbidity placing a huge burden on individuals, families and health systems, especially in low- and middle-income countries (LMICs). This rising disease burden calls for policy responses that engage the entire health care system. This study aims to synthesize evidence on how people with NCDs choose their healthcare providers in LMICs, and the outcomes of these choices, with a focus on private sector delivery. Methods A systematic search for literature following PRISMA guidelines was conducted. We extracted and synthesised data on the determinants and outcomes of private health care utilisation for NCDs in LMICs. A quality and risk of bias assessment was performed using the Mixed Methods Appraisal Tool (MMAT). Results We identified 115 studies for inclusion. Findings on determinants and outcomes were heterogenous, often based on a particular country context, disease, and provider. The most reported determinants of seeking private NCD care were patients having a higher socioeconomic status; greater availability of services, staff and medicines; convenience including proximity and opening hours; shorter waiting times and perceived quality. Transitioning between public and private facilities is common. Costs to patients were usually far higher in the private sector for both inpatient and outpatient settings. The quality of NCD care seems mixed depending on the disease, facility size and location, as well as the aspect of quality assessed. Conclusion Given the limited, mixed and context specific evidence currently available, adapting health service delivery models to respond to NCDs remains a challenge in LMICs. More robust research on health seeking behaviours and outcomes, especially through large multi-country surveys, is needed to inform the effective design of mixed health care systems that effectively engage both public and private providers. Trial registration PROSPERO registration number CRD42022340059.

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Section: Resultsmentioning

confidence: 99%

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

Brindley,

Wijemunige,

Dieteren

et al. 2024

BMC Health Serv Res

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“…Detailed information about each article is included in Table S1. The majority of articles reported on studies conducted in countries in Africa (32%), [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] followed by South-East Asia (30%), [38][39][40][41][42][43][44][45][46][47][48][49][50][51]71 the Middle East (20%), [52][53][54][55][56][57][58][59][60][61] Latin America (16%), [62][63][64][65][66][67][68][69] and Eastern Europe (2%). 45,...…”

Section: Resultsmentioning

confidence: 99%

“…Detailed information about each article is included in Table S1 . The majority of articles reported on studies conducted in countries in Africa (32%), 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 followed by South‐East Asia (30%), 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 71 the Middle East (20%), 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 Latin America (16%), 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 and Eastern Europe (2%). 45 , 70 Two articles reported on patients from more than one country.…”

Section: Resultsmentioning

confidence: 99%

“…Six out of the 8 articles 62 , 63 , 64 , 65 , 66 , 67 , 69 from this region investigated factors associated to the patient interval in Mexico, 64 , 65 , 66 , 69 Brazil, 63 and Peru. 67 Lower socio‐economic status, education, or income, not having insurance, not being married, and having low material social support 63 were related to longer patient intervals in studies from Latin America.…”

Section: Resultsmentioning

confidence: 99%

“…The pooled duration of the patient interval from studies from Latin America, representing Colombia, Mexico, Brazil, and Peru, was slightly longer than a month, specifically 39 days (95% CI 24-55), Six out of the 8 articles [62][63][64][65][66][67]69 from this region investigated factors associated to the patient interval in Mexico, [64][65][66]69 Brazil, 63 and Peru. 67 Lower socio-economic status, education, or income, not having insurance, not being married, and having low material social support 63 were related to longer patient intervals in studies from Latin America.…”

Section: Latin Americamentioning

confidence: 99%

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Duration of the patient interval in breast cancer and factors associated with longer delays in low‐and middle‐income countries: A systematic review with meta‐analysis

et al. 2022

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Objective: Breast cancer survival is lower in low-and middle-income countries (LMICs) partially due to many women being diagnosed with late-stage disease. The patient interval refers to the time elapsed between the detection of symptoms and the first consultation with a healthcare provider and is considered one of the core indicators for early diagnosis and treatment. The goal of the current research was to conduct a meta-analysis of the duration of the patient interval in LMICs and investigate the socio-demographic and socio-cultural factors related to longer delays in presentation. Methods:We conducted a systematic review with meta-analysis (pre-registered protocol CRD42020200752). We searched seven information sources (2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021)(2022) and included 50 articles reporting the duration of patient intervals for 18,014 breast cancer patients residing in LMICs. Results:The longest patient intervals were reported in studies from the Middle East (3-4 months), followed by South-East Asia (2 months), Africa (1-2 months), Latin America (1 month), and Eastern Europe (1 month). Older age, not being married, lower socio-economic status, illiteracy, low knowledge about cancer, disregarding symptoms or not attributing them to cancer, fear, negative beliefs about cancer, and low social support were related to longer delays across most regions. Longer delays were also related to use of alternative medicine in the Middle East, South-East Asia, and Africa and distrust in the healthcare system in Eastern Europe. Conclusions:There is large variation in the duration of patient intervals across LMICs in different geographical regions. Patient intervals should be reduced and, for this purpose, it is important to explore their determinants taking into account the social, cultural, and economic context.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Healthcare Delay in Breast Cancer Patients: A Case Study in a Low-Density Population Region from Mexico

Abstract: Delay in treatment was largely due to system delay. Only a few variables explained this delay. Clinical stage had the strongest effect on initiation of first oncologic treatment.

Cited by 2 publications

References 22 publications

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

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

Duration of the patient interval in breast cancer and factors associated with longer delays in low‐and middle‐income countries: A systematic review with meta‐analysis

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