Dr Khursheda Akhtar, Assistant Professor, Community Medicine, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2021 Oct;30(4):1124-1130.
Female breast cancer can be diagnosed easily; but due to inappropriate health care utilization, health-seeking is lag behind. The objectives of the study were to find out the pattern of utilization of health care during breast cancer diagnosis and treatment and their health seeking time. We conducted this cross sectional study for one year; from July 2017 to June 2018 among 200 newly diagnose patients with breast cancer whose were selected randomly from National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from the listed patients who attended at the outpatient department of chemotherapy day care center for treatment. Delay in reporting, wrong reporting, double reporting, delay in hospital admission, long queue for administrative work and delay to reach cancer specialist play a role in utilization of health care. Results showed that health care service delivery and utilization was found to be significant by (p<0.05) associated with the provider delay (p=0.010), total delay (p=0.017), delay to consult with cancer specialist (p<0.0001). By logistic regression it analyzed that utilization of health care there had 2 times more likely to cause provider delay (OR=2.5; 95% CI 1.087-5.762) p=0.03. Utilization of health care influenced stage of cancer with delay help seeking and diagnostic institution also. As low middle income country, like Bangladesh, delays in seeking consultation, late presentation and the availability of breast cancer management for all patients, represent major challenges.
女性乳腺癌的诊断较为容易，但由于医疗保健利用不合理，导致寻求医疗服务的时间滞后。本研究旨在探讨乳腺癌诊断和治疗过程中的医疗保健利用模式及其寻求医疗服务的时间。我们开展了一项为期一年的横断面研究，于 2017 年 7 月至 2018 年 6 月期间，在孟加拉国达卡国家癌症研究所和医院，随机选择了 200 名新诊断的乳腺癌患者进行研究。这些患者是从参加化疗日间护理中心门诊治疗的患者名单中选择的。延迟报告、错误报告、双重报告、延迟住院、行政工作排队时间长以及延迟接触癌症专家等因素都会影响医疗保健的利用。研究结果表明，医疗保健服务的提供和利用与提供者延迟（p=0.010）、总延迟（p=0.017）、咨询癌症专家的延迟（p<0.0001）显著相关（p<0.05）。通过逻辑回归分析发现，医疗保健的利用更有可能导致提供者延迟（OR=2.5；95%CI 1.087-5.762），p=0.03。医疗保健的利用影响癌症的分期，寻求医疗服务的时间延迟和诊断机构也会影响癌症的分期。孟加拉国等中低收入国家面临着寻求咨询的延迟、晚期就诊以及所有患者都能获得乳腺癌管理等重大挑战。
