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北爱尔兰乳腺癌诊断与治疗间隔期间私人护理的作用:对注册数据的分析。

The role of private care in the interval between diagnosis and treatment of breast cancer in Northern Ireland: an analysis of Registry data.

机构信息

School of Business and Economics, Economics of Cancer Research Group, NUI Galway, Galway Ireland.

出版信息

BMJ Open. 2013 Dec 3;3(12):e004074. doi: 10.1136/bmjopen-2013-004074.

Abstract

OBJECTIVE

To examine the differences in the interval between diagnosis and initiation of treatment among women with breast cancer in Northern Ireland.

DESIGN

A cross-sectional observational study.

SETTING

All breast cancer care patients in the Northern Ireland Cancer Registry in 2006.

PARTICIPANTS

All women diagnosed and treated for breast cancer in Northern Ireland in 2006.

MAIN OUTCOME MEASURE

The number of days between diagnosis and initiation of treatment for breast cancer.

RESULTS

The mean (median) interval between diagnosis and initiation of treatment among public patients was 19 (15) compared with 14 (12) among those whose care involved private providers. The differences between individual public providers were as marked as those between the public and private sector-the mean (median) ranging between 14 (12) and 25 (22) days. Multivariate models revealed that the differences were evident when a range of patient characteristics were controlled for including cancer stage.

CONCLUSIONS

A relatively small number of women received care privately in Northern Ireland but experienced shorter intervals between diagnosis and initiation of treatment than those who received care wholly in the public system. The variation among public providers was as great as that between the public and private providers. The impact of such differences on survival and in light of waiting time targets introduced in Northern Ireland warrants investigation.

摘要

目的

考察北爱尔兰女性乳腺癌患者在诊断与开始治疗之间的间隔差异。

设计

横断面观察性研究。

地点

2006 年北爱尔兰癌症登记处的所有乳腺癌护理患者。

参与者

2006 年在北爱尔兰被诊断和治疗乳腺癌的所有女性。

主要观察指标

乳腺癌诊断与治疗开始之间的天数。

结果

与接受私人医疗服务的患者相比,接受公共医疗服务的患者的平均(中位数)间隔为 19(15)天,而接受私人医疗服务的患者为 14(12)天。各个公共提供者之间的差异与公共和私营部门之间的差异一样明显——平均值(中位数)在 14(12)至 25(22)天之间。多变量模型显示,在控制了包括癌症分期在内的一系列患者特征后,这些差异仍然存在。

结论

在北爱尔兰,只有相对较少的女性接受私人医疗服务,但与完全接受公共系统医疗服务的女性相比,她们在诊断与开始治疗之间的间隔更短。公共提供者之间的差异与公共和私人提供者之间的差异一样大。这些差异对生存的影响以及考虑到北爱尔兰引入的等待时间目标,值得进一步调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/3855491/f79bf2178a42/bmjopen2013004074f01.jpg

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