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Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries

INTRODUCTION: Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners’ (PCPs’) clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan reg...

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Autores principales: Petek, Davorina, Assenova, Radost, Foreva, Gergana, Babić, Svjetlana Gašparović, Šter, Marija Petek, Prebil, Nuša, Puia, Aida, Smyrnakis, Emmanouil, Harris, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8776292/
https://www.ncbi.nlm.nih.gov/pubmed/35111265
http://dx.doi.org/10.2478/sjph-2022-0007
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author Petek, Davorina
Assenova, Radost
Foreva, Gergana
Babić, Svjetlana Gašparović
Šter, Marija Petek
Prebil, Nuša
Puia, Aida
Smyrnakis, Emmanouil
Harris, Michael
author_facet Petek, Davorina
Assenova, Radost
Foreva, Gergana
Babić, Svjetlana Gašparović
Šter, Marija Petek
Prebil, Nuša
Puia, Aida
Smyrnakis, Emmanouil
Harris, Michael
author_sort Petek, Davorina
collection PubMed
description INTRODUCTION: Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners’ (PCPs’) clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania). METHODS: PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors. Participants were also asked to make clinical decisions in a vignette of a patient with possible lung cancer. RESULTS: The survey was completed by 475 PCPs. There were significant national differences in PCPs’ direct access to investigations, particularly to advanced imaging. PCPs from Bulgaria, Greece, and Romania were more likely to organise relevant investigations. The highest specialist referral rates were in Bulgaria and Romania. PCPs in Bulgaria were less likely to have access to clinical guidelines, and PCPs from Slovenia and Croatia were more likely to have access to a cancer fast-track specialist appointment system. The PCPs’ country had a significant effect on their likelihood of investigating or referring the patient. CONCLUSIONS: There are large differences between Balkan region countries in PCPs’ levels of direct access to investigations. When faced with a vignette of a patient with the possibility of having lung cancer, their investigation and referral rates vary considerably. To reduce diagnostic delay in lung cancer, direct PCP access to advanced imaging, availability of relevant clinical guidelines, and fast-track referral systems are needed.
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spelling pubmed-87762922022-02-01 Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries Petek, Davorina Assenova, Radost Foreva, Gergana Babić, Svjetlana Gašparović Šter, Marija Petek Prebil, Nuša Puia, Aida Smyrnakis, Emmanouil Harris, Michael Zdr Varst Original Scientific Article INTRODUCTION: Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners’ (PCPs’) clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania). METHODS: PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors. Participants were also asked to make clinical decisions in a vignette of a patient with possible lung cancer. RESULTS: The survey was completed by 475 PCPs. There were significant national differences in PCPs’ direct access to investigations, particularly to advanced imaging. PCPs from Bulgaria, Greece, and Romania were more likely to organise relevant investigations. The highest specialist referral rates were in Bulgaria and Romania. PCPs in Bulgaria were less likely to have access to clinical guidelines, and PCPs from Slovenia and Croatia were more likely to have access to a cancer fast-track specialist appointment system. The PCPs’ country had a significant effect on their likelihood of investigating or referring the patient. CONCLUSIONS: There are large differences between Balkan region countries in PCPs’ levels of direct access to investigations. When faced with a vignette of a patient with the possibility of having lung cancer, their investigation and referral rates vary considerably. To reduce diagnostic delay in lung cancer, direct PCP access to advanced imaging, availability of relevant clinical guidelines, and fast-track referral systems are needed. Sciendo 2022-01-03 /pmc/articles/PMC8776292/ /pubmed/35111265 http://dx.doi.org/10.2478/sjph-2022-0007 Text en © 2022 National Institute of Public Health, Slovenia, published by Sciendo https://creativecommons.org/licenses/by-nc-nd/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
spellingShingle Original Scientific Article
Petek, Davorina
Assenova, Radost
Foreva, Gergana
Babić, Svjetlana Gašparović
Šter, Marija Petek
Prebil, Nuša
Puia, Aida
Smyrnakis, Emmanouil
Harris, Michael
Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries
title Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries
title_full Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries
title_fullStr Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries
title_full_unstemmed Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries
title_short Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries
title_sort primary care system factors and clinical decision-making in patients that could have lung cancer: a vignette study in five balkan region countries
topic Original Scientific Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8776292/
https://www.ncbi.nlm.nih.gov/pubmed/35111265
http://dx.doi.org/10.2478/sjph-2022-0007
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