Access of patients with breast and lung cancer to chemotherapy treatment in public and private hospitals in the city of Buenos Aires

Int J Qual Health Care. 2019 Nov 30;31(9):682-690. doi: 10.1093/intqhc/mzz047.

Abstract

Objectives: Describe the time elapsed from the diagnosis to treatment with chemotherapy for patients with breast and lung cancer at public and private hospitals in Buenos Aires.

Design: Retrospective cohort study.

Setting: Three public and three private academic hospitals in Buenos Aires.

Participants: Patients with breast (n = 168) or lung cancer (n = 100) diagnosis treated with chemotherapy.

Main outcomes measures: Clinical and sociodemographic data were collected in a stratified sample. We used the Kaplan-Meier estimator to analyse the time elapsed and the log rank test to compare both groups.

Results: For breast cancer patients, median time elapsed between diagnosis and treatment with chemotherapy was 76 days (95% CI: 64-86) in public and 60 days (95% CI: 52-65) in private hospitals (P = 0.0001). For adjuvant and neoadjuvant treatments, median time was 130 (95% CI: 109-159) versus 64 (95% CI: 56-73) days (P < 0.0001) and 57 days (95% CI: 49-75) versus 26 (95% CI: 16-41) days, respectively (P = 0.0002). There were no significant differences in the time from first consultation to diagnosis. In patients with lung cancer, median time from diagnosis to treatment was 71 days (95% CI: 60-83) in public hospitals and 31 days (95% CI: 24-39) in private hospitals (P = 0.0002). In the metastatic setting, median time to treatment was 63 days (95% CI: 45-83) in public and 33 (95% CI: 26-44) days in private hospitals (P = 0.005).

Conclusions: There are significant disparity in the access to treatment with chemotherapy for patients in Buenos Aires, Argentina.

Keywords: Argentina; access; breast cancer; chemotherapy; lung cancer.

MeSH terms

  • Adult
  • Aged
  • Argentina
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Cohort Studies
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Hospitals, Private / statistics & numerical data
  • Hospitals, Public / statistics & numerical data
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Lung Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / statistics & numerical data
  • Retrospective Studies
  • Time-to-Treatment / statistics & numerical data*