Ítem
Acceso Abierto

Understanding the health system drivers of delayed cancer diagnosis in public healthcare networks of Chile, Colombia and Ecuador: A qualitative study with health professionals, managers and policymakers

Mostrar el registro sencillo de la publicación
dc.creatorFronteira, Inêsspa
dc.creatorVargas, Ingridspa
dc.creatorMarques, Patriciaspa
dc.creatorGama, Anaspa
dc.creatorPerelman, Julianspa
dc.creatorRodríguez, Estefaníaspa
dc.creatorRuiz, Danielspa
dc.creatorPereira, Hugospa
dc.creatorDueñas, Ivánspa
dc.creatorDuarte, Oscarspa
dc.creatorLancheros, Lilianaspa
dc.creatorOByrne, Mauriciospa
dc.creatorTorres, Rafaelspa
dc.creatorVelandia, Omarspa
dc.creatorMerchán, Juan Gabrielspa
dc.creatorCala, Lilian Gabriela Fuentesspa
dc.creatorArellano, Ana Maríaspa
dc.creatorCristancho, Pablospa
dc.creatorRangel, María Camilaspa
dc.creatorCardozo Guzmán, Carol Ximenaspa
dc.creatorPinzón, Angelaspa
dc.creatorRestrepo, Ana Mariaspa
dc.creatorGarcia, Virginiaspa
dc.creatorStephens, Gloriaspa
dc.creatorAravena, Carmenspa
dc.creatorTabilo, Cristopherspa
dc.creatorHartwig, Guillermospa
dc.creatorCerda, Berta Fuentesspa
dc.creatorStock, Rodneyspa
dc.creatorAbarca, Isabelspa
dc.creatorGonzález, Paolaspa
dc.creatorAlvarez, Andreaspa
dc.creatorGuzmán, Isabelspa
dc.creatorBass, Camilospa
dc.creatorOyarce, Ana Maríaspa
dc.creatorGarmendia, María Luisaspa
dc.creatorSerrano-Blanco, Antonispa
dc.creatorGil-Girbau, Montserratspa
dc.creatorArroyo-Uriarte, Paulaspa
dc.creatorAznar-Lou, Ignaciospa
dc.creatorFernández, Zaharaspa
dc.creatorEspinel, Verónicaspa
dc.creatorOliver, Aidaspa
dc.creatorVazquez, M.L.spa
dc.creatorVázquez, María-Luisaspa
dc.creatorDias, Sóniaspa
dc.creatorBorras, Josep M.spa
dc.creatorJervelund, Signe Smithspa
dc.creatorRubio-Valera, Mariaspa
dc.creatorPeralta, Andrésspa
dc.creatorTorres, Ana-Lucíaspa
dc.creatorEguiguren, Pamelaspa
dc.creatorMogollón Pérez, Amparo Susanaspa
dc.date.accessioned2025-07-21T16:56:40Z
dc.date.available2025-07-21T16:56:40Z
dc.date.created2025-01-01spa
dc.date.issued2025-01-01spa
dc.description.abstractAlthough the greatest delays in cancer diagnosis in Latin America occur in the provider interval little is known about the related factors. This study aims to analyze factors influencing access to cancer diagnosis -from initial contact with health services to confirmation- from institutional stakeholders' perspective in public healthcare networks of Chile, Colombia, and Ecuador. A qualitative, descriptive-interpretative study was conducted in two networks per country, using semi-structured individual interviews (n = 118; 23 to 58, per country) with a criterion sample of health professionals and administrative personnel from primary care (PC) (n = 41) and secondary/tertiary care hospitals (n = 47), network managers and policymakers (n = 30). The final sample size was reached through saturation. Thematic content analysis was performed, segmented by country. The analysis reveals interacting factors that cause cumulative delays throughout the patient's diagnostic pathway within healthcare networks, with differences between countries. In all three, informants identify similar characteristics of the networks: structural (deficits in diagnostic resources; geographical accessibility), organizational factors (long waiting times, especially after referral), and the limited knowledge and experience of PC doctors, which all lead to delayed diagnosis. In Chile and Colombia, health policy barriers related to care rationing/prioritization policies that hampered access to tests, and in Chile, increased delays for non-prioritized conditions. Country-specific barriers related to the organization of healthcare system also emerge: in Chile, private services subcontracting and the voucher system for using them; in Colombia, the management of care by insurers (care authorizations; fragmented and short-term contracting of providers); and in Ecuador, underfunding of the system. The barriers most affect the elderly, those with low socioeconomic status, with limited support networks, and rural areas residents. The results reveal relevant barriers in access to timely cancer diagnosis which can and should be addressed with specific cancer diagnosis policies and general measures that strengthen public healthcare systems and networks.eng
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.1016/j.socscimed.2024.117499spa
dc.identifier.issn0277-9536spa
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/46119
dc.language.isoengspa
dc.publisherElsevierspa
dc.relation.ispartofSocial Science & Medicine Volume 365, January 2025, 117499spa
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S0277953624009535?via%3Dihubspa
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationalspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accesoAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/spa
dc.sourceSocial Science & Medicinespa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordEarly diagnosis of cancereng
dc.subject.keywordAccess to healthcareeng
dc.subject.keywordHealth inequitieseng
dc.subject.keywordQualitative researcheng
dc.subject.keywordHealth services researcheng
dc.subject.keywordLatin Americaeng
dc.titleUnderstanding the health system drivers of delayed cancer diagnosis in public healthcare networks of Chile, Colombia and Ecuador: A qualitative study with health professionals, managers and policymakersspa
dc.typearticlespa
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersionspa
dc.type.spaArtículo de Investigaciónspa
Archivos
Bloque original
Mostrando1 - 1 de 1
Miniatura
Nombre:
Understanding_the_health_system_drivers_of_delayed_cancer_diagnosis.pdf
Tamaño:
4.47 MB
Formato:
Adobe Portable Document Format
Descripción:
Descargar
Colecciones
Artículos