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Sökning: onr:"swepub:oai:DiVA.org:lnu-81295" > Identifying importa...

  • Harris, MichaelUniversity of Bath, UK;University of Bern, Switzerland (författare)

Identifying important health system factors that influence primary care practitioners' referrals for cancer suspicion : a European cross-sectional survey.

  • Artikel/kapitelEngelska2018

Förlag, utgivningsår, omfång ...

  • 2018-09-05
  • BMJ Publishing Group Ltd,2018
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:lnu-81295
  • https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-81295URI
  • https://doi.org/10.1136/bmjopen-2018-022904DOI
  • https://lup.lub.lu.se/record/d32f4fba-6ef0-40b4-a2b6-382039857e64URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • OBJECTIVES: Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners' (PCPs') referral decisions is lacking.This study analyses health system factors potentially influencing PCPs' referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.DESIGN: Based on a content-validity consensus, a list of 45 items relating to a PCP's decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs' referral decision-making.SETTING: A primary care study; 25 participating centres in 20 European countries.PARTICIPANTS: 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.OUTCOME MEASURES: The factors derived from items related to PCPs' referral decision-making. Mean factor scores were produced for each country, allowing comparisons.RESULTS: Factor analysis identified five underlying factors: PCPs' ability to refer; degree of direct patient access to secondary care; PCPs' perceptions of being under pressure; expectations of PCPs' role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.CONCLUSIONS: Five healthcare system factors influencing PCPs' referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Vedsted, PeterAarhus University, Denmark (författare)
  • Esteva, MagdalenaBalearic Islands Health Research Institute (IdISBa), Spain,Instituto de Investigación sanitaria Illes Balears (idISBA) (författare)
  • Murchie, PeterUniversity of Aberdeen, UK (författare)
  • Aubin-Auger, IsabelleUniversité Paris Diderot, France (författare)
  • Azuri, JosephTel Aviv University, Israel (författare)
  • Brekke, MetteUniversity of Oslo, Norway (författare)
  • Buczkowski, KrzysztofNicolaus Copernicus University, Poland (författare)
  • Buono, NicolaNational Society of Medical Education in General Practice (SNaMID), Italy,National Italian Society of Medical Education In General Practice (författare)
  • Costiug, EmilianaIuliu Hatieganu University of Medicine and Pharmacy, Romania,University of Medicine and Pharmacy, Cluj-Napoca (författare)
  • Dinant, Geert-JanMaastricht University, Netherlands (författare)
  • Foreva, GerganaMedical Center BROD, Plovdiv, Bulgaria,Medical Center BROD, Benkovski (författare)
  • Gašparović Babić, SvjetlanaThe Teaching Institute of Public Health of Primorsko-goranska County, Croatia,University of Rijeka (författare)
  • Hoffman, RobertTel Aviv University, Israel (författare)
  • Jakob, EvaCentro de Saúde Sarria, Spain (författare)
  • Koskela, Tuomas HUniversity of Tampere, Finland (författare)
  • Marzo-Castillejo, MercèInstitut Catala De La Salut, Spain,Institut Universitari d’Investigació en Atenció Primària Jordi Gol (författare)
  • Neves, Ana LuísaImperial College London, UK;University of Porto, Porto, Portugal (författare)
  • Petek, DavorinaUniversity of Ljubljana, Slovenia (författare)
  • Petek Ster, MarijaUniversity of Ljubljana, Slovenia (författare)
  • Sawicka-Powierza, JolantaMedical University of Bialystok, Poland (författare)
  • Schneider, AntoniusTechnische Universität München, Germany (författare)
  • Smyrnakis, EmmanouilAristotle University of Thessaloniki, Greece (författare)
  • Streit, SvenUniversity of Bern, Switzerland (författare)
  • Thulesius, HansLund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Lund University, Sweden(Swepub:lu)smi-hth (författare)
  • Weltermann, BirgittaUniversity of Bonn, Germany (författare)
  • Taylor, GordonUniversity of Bath, UK (författare)
  • University of Bath, UK;University of Bern, SwitzerlandAarhus University, Denmark (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:BMJ Open: BMJ Publishing Group Ltd8:9, s. 1-132044-6055

Internetlänk

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  • BMJ Open (Sök värdpublikationen i LIBRIS)

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