TY - JOUR
T1 - Health care providers' assessments of the quality of advanced-cancer care in latin american medical institutions
T2 - A comparison of predictors in five countries: Argentina, Brazil, Cuba, Mexico, and Peru
AU - Torres-Vigil, Isabel
AU - Aday, Lu Ann
AU - Reyes-Gibby, Cielito
AU - De Lima, Liliana
AU - Herrera, Angelica P.
AU - Mendoza, Tito
AU - Cleeland, Charles S.
PY - 2008/5/9
Y1 - 2008/5/9
N2 - This paper describes an innovative Pan-American survey on advanced-cancer care and examines the quality-of-care provided by Latin American institutions. A convenience sample of 777 physicians and nurses who treat cancer patients in Argentina, Brazil, Cuba, Mexico, and Peru were surveyed. Providers were identified through mass mailings, distribution at professional meetings and conferences, collaboration with regional institutions, professional organizations, and PAHO and online posting. Multiple linear regression analyses were conducted to identify predictors of quality-of-care assessments in each country. The five predictive models were subsequently compared descriptively. Higher access to care ratings and greater availability of end-of-life services corresponded with improved institutional quality-of-care ratings for all five countries. Barring respondents from Cuba, providers from the other four nations who practice in public institutions rated the quality of advanced-cancer care in their own institutions lower than those practicing in private hospitals or specialized cancer centers. Other institutional quality-of-care predictors included type of city, affordability-of-care ratings, availability of opioid analgesics, where patients die, barriers to cancer pain management, and the provider's specialty and gender. These findings highlight the need for providing accessible care and services to improve the quality of advanced-cancer care in Latin American institutions. Efforts should be aimed at improving the care offered in public institutions and addressing other types of disparities that may exist within countries by creating supportive and palliative cancer care programs that are accessible and affordable to those most in need.
AB - This paper describes an innovative Pan-American survey on advanced-cancer care and examines the quality-of-care provided by Latin American institutions. A convenience sample of 777 physicians and nurses who treat cancer patients in Argentina, Brazil, Cuba, Mexico, and Peru were surveyed. Providers were identified through mass mailings, distribution at professional meetings and conferences, collaboration with regional institutions, professional organizations, and PAHO and online posting. Multiple linear regression analyses were conducted to identify predictors of quality-of-care assessments in each country. The five predictive models were subsequently compared descriptively. Higher access to care ratings and greater availability of end-of-life services corresponded with improved institutional quality-of-care ratings for all five countries. Barring respondents from Cuba, providers from the other four nations who practice in public institutions rated the quality of advanced-cancer care in their own institutions lower than those practicing in private hospitals or specialized cancer centers. Other institutional quality-of-care predictors included type of city, affordability-of-care ratings, availability of opioid analgesics, where patients die, barriers to cancer pain management, and the provider's specialty and gender. These findings highlight the need for providing accessible care and services to improve the quality of advanced-cancer care in Latin American institutions. Efforts should be aimed at improving the care offered in public institutions and addressing other types of disparities that may exist within countries by creating supportive and palliative cancer care programs that are accessible and affordable to those most in need.
KW - Cancer
KW - Disparities
KW - Latin America
KW - Opioids
KW - Pain
KW - Palliative care
KW - Quality of care
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U2 - 10.1080/15360280801989195
DO - 10.1080/15360280801989195
M3 - Article
C2 - 19042817
AN - SCOPUS:60549086020
SN - 1536-0288
VL - 22
SP - 7
EP - 20
JO - Journal of Pain and Palliative Care Pharmacotherapy
JF - Journal of Pain and Palliative Care Pharmacotherapy
IS - 1
ER -