Clinical pathways of breast cancer patients treated in the Federal District, Brazil

dc.contributor.authorBarros, Angela Ferreira [UNESP]
dc.contributor.authorAraujo, Jeniffer Melo de
dc.contributor.authorMurta-Nascimento, Cristiane [UNESP]
dc.contributor.authorDias, Adriano [UNESP]
dc.contributor.institutionSecretaria Estado Saude Dist Fed
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionHosp Alvorada Brasilia
dc.date.accessioned2019-10-04T12:34:54Z
dc.date.available2019-10-04T12:34:54Z
dc.date.issued2019-01-01
dc.description.abstractOBJECTIVE: To identify the clinical pathways of women with breast cancer treated in public hospitals, and to analyze the factors that influence the time interval between the first appointment and the start of therapy. METHODS: A cross-sectional study was conducted with 600 women with breast cancer treated in nine public hospitals in the Brazilian Federal District. Patients were interviewed between September 2012 and September 2014. Simple and multiple logistic regression models were adjusted to evaluate the variables associated with the time interval studied. The most frequent pathway was the one that started in primary care with following care in the therapy service (28.9%). In the multiple adjustment, factors associated to a longer time interval between the first appointment and therapy were: lower family income (OR = 1.89; 95% CI 1.32-2.68), the first appointment in public services (OR = 1.78; 95% CI 1.20-2.64), care in more than two health services in the clinical pathway (OR = 1.71; 95% CI 1.19-2.44); and obtaining the anatomopathological analysis of the biopsy in public services instead of private health services (OR = 1.87; 95% CI 1.29-2.71). Independently, the implementation of specialist appointment scheduling, with care regulation, was associated with a shorter time interval between first appointment and therapy (OR = 0.33; 95% CI 0.16-0.65). CONCLUSIONS: We observed that multiple pathways were covered by women with breast cancer treated in public services of the Federal District. Socioeconomic iniquities and several aspectos of the pathways covered were associated with a longer time interval between the first appointment and the start of breast cancer therapy.en
dc.description.affiliationSecretaria Estado Saude Dist Fed, Escola Super Ciencias Saude, Brasilia, DF, Brazil
dc.description.affiliationUniv Estadual Paulista, Fac Med, Programa Posgrad Saude Colet, Botucatu, SP, Brazil
dc.description.affiliationHosp Alvorada Brasilia, Brasilia, DF, Brazil
dc.description.affiliationUniv Estadual Paulista, Fac Med, Programa Posgrad Saude Colet, Dept Saude Publ, Botucatu, SP, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, Fac Med, Programa Posgrad Saude Colet, Botucatu, SP, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, Fac Med, Programa Posgrad Saude Colet, Dept Saude Publ, Botucatu, SP, Brazil
dc.description.sponsorshipFundacao de Ensino e Pesquisa em Ciencias da Saude da Secretaria de Estado de Saude do Distrito Federal
dc.description.sponsorshipIdFundacao de Ensino e Pesquisa em Ciencias da Saude da Secretaria de Estado de Saude do Distrito Federal: 41
dc.description.sponsorshipIdFundacao de Ensino e Pesquisa em Ciencias da Saude da Secretaria de Estado de Saude do Distrito Federal: 064.000.455/2013
dc.format.extent11
dc.identifierhttp://dx.doi.org/10.11606/S1518-8787.2019053000406
dc.identifier.citationRevista De Saude Publica. Sao Paulo: Revista De Saude Publica, v. 53, 11 p., 2019.
dc.identifier.doi10.11606/S1518-8787.2019053000406
dc.identifier.fileS0034-89102019000100211.pdf
dc.identifier.issn0034-8910
dc.identifier.scieloS0034-89102019000100211
dc.identifier.urihttp://hdl.handle.net/11449/185376
dc.identifier.wosWOS:000457310300009
dc.language.isoeng
dc.publisherRevista De Saude Publica
dc.relation.ispartofRevista De Saude Publica
dc.rights.accessRightsAcesso aberto
dc.sourceWeb of Science
dc.subjectBreast Neoplasms, therapy
dc.subjectTime-to-Treatment
dc.subjectHealth Care Quality, Access, and Evaluation
dc.subjectHealth Status Disparities
dc.subjectHealth Services Accessibility
dc.titleClinical pathways of breast cancer patients treated in the Federal District, Brazilen
dc.typeArtigo
dcterms.rightsHolderRevista De Saude Publica
unesp.author.orcid0000-0001-8686-1079[3]
unesp.author.orcid0000-0001-6895-372X[4]

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