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[宫颈癌的及时门诊治疗:巴西米纳斯吉拉斯州女性居住地区的影响]

[Timely outpatient treatment of cervical cancer: the influence of region of residence for women in the state of Minas Gerais, Brazil].

作者信息

Moreira Daniela Pena, Santos Marcos Antonio da Cunha, Pilecco Flávia Bulegon, Dumont-Pena Érica, Reis Ilka Afonso, Cherchiglia Mariangela Leal

机构信息

Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

出版信息

Cad Saude Publica. 2022 Oct 24;38(10):e00277521. doi: 10.1590/0102-311XPT277521. eCollection 2022.

Abstract

This study aimed to investigate whether there is an association between the Extended Health Regions (EHR) of residence in the state of Minas Gerais, Brazil, and the interval between diagnosis and start of treatment for women who underwent outpatient treatment (chemotherapy or radiotherapy) for cervical cancer by the Brazilian Unified National Health System (SUS), between 2001 and 2015. This is a cross-sectional study, part of a cohort with 8,857 women. Negative binomial regression models were used to evaluate the association of EHR of residence and the interval between diagnosis and start of treatment (in days), considering a significance level of 5%. The models were constructed using blocks of sociodemographic, clinical, and treatment-related covariates. It was found that the EHR of residence of women is associated with the interval between diagnosis and start of treatment. The northern EHR was the region of the state where the average time to start treatment was lower, and not residing in this EHR increases the average time to start treatment between 24% and 93% compared to other EHRs in the state. The disparity in the interval between diagnosis and start of treatment between the regions of Minas Gerais is evident. The availability of services enabled for the treatment of cancer in the EHRs does not necessarily results in a greater agility for the start of treatment. Understanding the flows of Oncology Care Networks and their regional differences is essential to improve public policies that ensure compliance with current laws, such as Law n. 12,732/2012, which recommends the start of treatment for cancer patients within 60 days after diagnosis.

摘要

本研究旨在调查巴西米纳斯吉拉斯州居民所在的扩展健康区域(EHR)与2001年至2015年间通过巴西统一国家卫生系统(SUS)接受门诊治疗(化疗或放疗)的宫颈癌女性患者的诊断与治疗开始间隔之间是否存在关联。这是一项横断面研究,是一个包含8857名女性的队列研究的一部分。使用负二项回归模型来评估居住的EHR与诊断和治疗开始间隔(以天为单位)之间的关联,显著性水平设定为5%。模型的构建使用了社会人口统计学、临床和治疗相关协变量的分组。研究发现,女性居住的EHR与诊断和治疗开始间隔有关。北部EHR是该州治疗开始平均时间较短的地区,与该州其他EHR相比,不住在这个EHR会使治疗开始的平均时间增加24%至93%。米纳斯吉拉斯州各地区在诊断和治疗开始间隔方面的差异很明显。EHR中用于癌症治疗的服务可用性并不一定会带来治疗开始的更大灵活性。了解肿瘤护理网络的流程及其区域差异对于改进确保遵守现行法律(如第12732/2012号法律,该法律建议癌症患者在诊断后60天内开始治疗)的公共政策至关重要。

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