Avtor/Urednik     Harris, Michael; Frey, Peter; Esteva, Magdalena; Gašparović-Babić, Svjetlana; Marzo-Castillejo, Mercè; Petek, Davorina; Petek Šter, Marija; Thulesius, Hans
Naslov     How the probability of presentation to a primary care clinician correlates with cancer survival rates
Tip     članek
Vol. in št.     Letnik 35, št. 1
Leto izdaje     2017
Obseg     str. 27-34
ISSN     1502-7724 - Scandinavian journal of primary health care
Jezik     eng
Abstrakt     Objective: European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in dif- ferent European countries, and how probability of presentation to a primary care clinician corre- lates with cancer survival rates. Design: Seventy-eight PCPs in a range of European countries assessed four vignettes represent- ing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates. Setting: A total of 14 countries. Subjects: Consensus groups of PCPs. Main outcome measures: Probability of initial presentation to a PCP for four clinical vignettes. Results: There was no significant correlation between overall national 1-year relative cancer sur- vival rates and the probability of initial presentation to a PCP ( r = -0.16, 95% CI = 0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r =- 0.57, 95% CI - 0.83 to - 0.12; ovary: r =- 0.13, 95% CI - 0.57 to 0.38; breast r = 0.14, 95% CI _ 0.36 to 0.58; bowel: r = 0.20, 95% CI = 0.31 to 0.62). Conclusions: There were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a PCP-as-gatekeeper system. While there was case-by-case variation, there was no overall evidence of a link between a higher prob- ability of initial consultation with a PCP and poorer cancer survival.
Proste vsebinske oznake     health care systems
cancer
diagnosis
sistem zdravstvenega varstva
rak
diagnoza