Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/10980
How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes
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ISSN: 0281-3432
eISSN: 1502-7724
WOS ID: 000396039600005
Scopus EID: 2-s2.0-85014571071
PMID: 28277044
Embase PUI: L618115696
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2017Document type
research articleCitation
Harris M, Frey P, Esteva M, Gasparovic Babic S, Marzo-Castillejo M, Petek D, et al. How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes. Scand J Prim Health Care. 2017;35(1):27-34. Epub 2017 Mar 6.Abstract
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 different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates. Design: Seventy-eight PCPs in a range of European countries assessed four vignettes representing 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 survival 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 probability of initial consultation with a PCP and poorer cancer survival.
Publisher version
https://dx.doi.org/10.1080/02813432.2017.1288692MeSH
Breast NeoplasmsGatekeeping
Humans
Intestinal Neoplasms
Neoplasms
Male
Probability
Referral and Consultation
Europe
Lung Neoplasms
Attitude of Health Personnel
Female
Ovarian Neoplasms
Survival Analysis
Primary Health Care
Physicians, Primary Care
Surveys and Questionnaires
DeCS
Análisis de SupervivenciaFemenino
Europa (Continente)
Control de Acceso
Actitud del Personal de Salud
Neoplasias Pulmonares
Masculino
Humanos
Neoplasias
Probabilidad
Neoplasias Intestinales
Derivación y Consulta
Encuestas y Cuestionarios
Neoplasias de la Mama
Atención Primaria de Salud
Médicos de Atención Primaria
Neoplasias Ováricas
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Atención Primaria de Mallorca - APMALL > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica