Social and clinical determinants of the use of health services in women with breast cancer (Cohort DAMA) Determinantes sociales y clínicos del uso de servicios sanitarios en mujeres con cáncer de mama (Cohorte DAMA)
Puigpinós-Riera, Rosa (Institut d'Investigació Biomèdica Sant Pau)
Castillo Gómez, Adán (Institut Hospital del Mar d'Investigacions Mèdiques)
Romero Morales, Anabel (Institut Hospital del Mar d'Investigacions Mèdiques)
Aller Hernández, Marta Beatriz ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Hospital del Mar d'Investigacions Mèdiques)
Castells, Xavier ![Identificador ORCID](/img/uab/orcid.ico)
(Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Sala, Maria ![Identificador ORCID](/img/uab/orcid.ico)
(Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Data: |
2019 |
Resum: |
Objective: To describe and analyse the factors associated with the use of health services (emergency departments, admissions and primary care) in women survivors of breast cancer diagnosed or treated in four university hospitals of Barcelona (Spain) between 2003 and 2013, within the framework of the Cohort DAMA project. Method: Descriptive design nested in a mixed cohort (Cohort Dama). We obtained sociodemographic information and information on the use of health services through a questionnaire, and on the tumour from the clinical history. Logistic regression models were performed, calculating the odds ratio of the use of health services (emergency departments, hospital admissions and primary care) raw and adjusted (aOR) by diagnostic method, the characteristics of the tumour and of the women and their 95% confidence intervals. Results: The presence of chronic diseases was associated with greater use of the three levels of care. A disadvantaged economic level increases the risk of use of emergency departments and primary care but not of hospital admissions, while a higher tumour stage is associated with a greater risk of admission. By age, those under 50 had a higher risk of using emergency departments and admissions. Conclusions: The factors associated with the use of health services differ according to the level of care (aOR: 3. 53 emergency departments, 1. 67 admissions, 3. 89 primary care) and treatment-derived complications (aOR: 1. 35 emergency departments, 1. 43 primary care). The presence of chronic disorders, younger age, disadvantaged social class, increases the risk of using services more than the tumour stage and treatment-derived complications. Neither the diagnostic method nor the survival time, nor the use of non-conventional therapies influence this. |
Ajuts: |
Instituto de Salud Carlos III PI13-01977
|
Drets: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. ![Creative Commons](/img/licenses/by-nc-nd.ico) |
Llengua: |
Castellà |
Document: |
Article ; recerca ; Versió publicada |
Matèria: |
Atención primaria ;
Breast cancer survivors ;
Clinical determinants ;
Determinantes ;
Emergency departments ;
Hospital admissions ;
Ingresos hospitalarios ;
Primary care ;
Social determinants ;
Supervivientes de cáncer de mama ;
Urgencias ;
Use of health services Uso de servicios sanitarios, sociales y clínicos |
Publicat a: |
Gaceta sanitaria, Vol. 33 Núm. 5 (septiembre 2019) , p. 434-441, ISSN 1578-1283 |
DOI: 10.1016/j.gaceta.2018.04.014
PMID: 30031657
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Registre creat el 2020-06-03, darrera modificació el 2024-07-31