School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia.
Institute for Breathing and Sleep (IBAS), Melbourne, Australia.
BMC Health Serv Res. 2023 Mar 16;23(1):261. doi: 10.1186/s12913-023-09154-8.
This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh.
A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables.
A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP.
The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals.
本研究旨在探讨孟加拉国肺癌患者在医疗保健寻求途径中及时性相关的因素。
通过在三家三级保健医院对 418 名肺癌患者进行面对面访谈，使用结构化问卷收集数据。通过对数秩检验，检验了患者的社会经济特征和医疗保健寻求行为对医疗保健间隔时间长度的差异。通过 Cox 比例风险（PH）回归分析，在调整其他变量变化的情况下，确定了间隔的预测因素。
更高的教育水平与首次接触医疗保健提供者（HCP）和诊断（中位数 81 天）以及治疗开始（中位数 101 天）之间的间隔时间较短显著相关（p<0.05）。更高的月家庭收入与从首次接触到诊断（中位数 91 天）、症状发作到诊断（中位数 99 天）、症状发作到治疗（中位数 122 天）以及首次接触任何 HCP 到治疗（中位数 111 天）的时间较短显著相关。在诊断前咨询额外的 HCP 与从首次接触任何 HCP 到诊断（中位数 127 天）、症状发作到诊断（中位数 154 天）、症状发作到治疗（中位数 205 天）以及首次接触任何 HCP 到治疗（中位数 174 天）的时间间隔较长显著相关。咨询非正式的 HCP 与从症状到治疗的时间间隔较长显著相关（中位数 171 天）。有一个以上的触发症状与症状发作与任何 HCP 首次接触之间的时间间隔较短显著相关。
本研究中用于评估肺癌护理及时性的预测因素影响了医疗保健寻求途径中的不同时间间隔。较高的教育和收入预示着间隔时间较短，而咨询非正式医疗保健提供者和多个提供者与间隔时间较长有关。
