Literature DB >> 21861597

Does the organizational structure of health care systems influence care-seeking decisions? A qualitative analysis of Danish cancer patients' reflections on care-seeking.

Rikke Sand Andersen1, Peter Vedsted, Frede Olesen, Flemming Bro, Jens Søndergaard.   

Abstract

OBJECTIVE: The absence of a more significant improvement in cancer survival in countries such as the UK and Denmark may be partly rooted in delayed care-seeking among cancer patients. Past research on patient delay has mainly focused on patient characteristics (e.g. sociodemographic and psychological factors and symptom recognition) as causes of delayed care-seeking, while few studies have examined how the organizational structure of health care systems may influence patients' reflections on seeking care. The aim of this study was to explore this relationship.
DESIGN: The analysis presented is based on semi-structured interviews with 30 cancer patients and their families.
RESULTS: The article raises two hypotheses on the relationship between structural elements of a health care system and people's reflections on seeking health care: (1) Gatekeeping introduces an asymmetrical relationship between the patient and the GP which potentially results in self-restricting care-seeking, (2) Continuity in the doctor-patient relationship may negatively influence patient reflections on access to health care, as the focus shifts from the medical issues of the consultation to reflections on how to properly interact with the GP and the system in which she/he is situated.
CONCLUSION: It is concluded that these hypotheses form a sound basis for further primary care research on how the organizational structure of health care systems influences patient reflections on access to medical care.

Entities:  

Mesh:

Year:  2011        PMID: 21861597      PMCID: PMC3347951          DOI: 10.3109/02813432.2011.585799

Source DB:  PubMed          Journal:  Scand J Prim Health Care        ISSN: 0281-3432            Impact factor:   2.581


  27 in total

1.  Do patients value continuity of care in general practice? An investigation using stated preference discrete choice experiments.

Authors:  David Turner; Carolyn Tarrant; Kate Windridge; Stirling Bryan; Mary Boulton; George Freeman; Richard Baker
Journal:  J Health Serv Res Policy       Date:  2007-07

2.  Comparative cancer survival information in Europe.

Authors:  Franco Berrino; Arduino Verdecchia; Jean Michel Lutz; Claudio Lombardo; Andrea Micheli; Riccardo Capocaccia
Journal:  Eur J Cancer       Date:  2009-02-13       Impact factor: 9.162

3.  Is primary care essential?

Authors:  B Starfield
Journal:  Lancet       Date:  1994-10-22       Impact factor: 79.321

4.  Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists.

Authors:  K Grumbach; J V Selby; C Damberg; A B Bindman; C Quesenberry; A Truman; C Uratsu
Journal:  JAMA       Date:  1999-07-21       Impact factor: 56.272

5.  Is gatekeeping better than traditional care? A survey of physicians' attitudes.

Authors:  E A Halm; N Causino; D Blumenthal
Journal:  JAMA       Date:  1997-11-26       Impact factor: 56.272

6.  The performativity of the service management discourse: "value creating customers" in health care.

Authors:  Lars Nordgren
Journal:  J Health Organ Manag       Date:  2008

7.  Barriers and triggers to seeking help for potentially malignant oral symptoms: implications for interventions.

Authors:  Suzanne E Scott; Elizabeth A Grunfeld; Vivian Auyeung; Mark McGurk
Journal:  J Public Health Dent       Date:  2009       Impact factor: 1.821

8.  Personal continuity and access in UK general practice: a qualitative study of general practitioners' and patients' perceptions of when and how they matter.

Authors:  Bruce Guthrie; Sally Wyke
Journal:  BMC Fam Pract       Date:  2006-02-24       Impact factor: 2.497

9.  Public awareness of cancer in Britain: a population-based survey of adults.

Authors:  K Robb; S Stubbings; A Ramirez; U Macleod; J Austoker; J Waller; S Hiom; J Wardle
Journal:  Br J Cancer       Date:  2009-12-03       Impact factor: 7.640

10.  Socioeconomic patient characteristics predict delay in cancer diagnosis: a Danish cohort study.

Authors:  Rikke Pilegaard Hansen; Frede Olesen; Henrik Toft Sørensen; Ineta Sokolowski; Jens Søndergaard
Journal:  BMC Health Serv Res       Date:  2008-02-28       Impact factor: 2.655

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  21 in total

1.  Quality deviations in cancer diagnosis: prevalence and time to diagnosis in general practice.

Authors:  Henry Jensen; Aase Nissen; Peter Vedsted
Journal:  Br J Gen Pract       Date:  2014-02       Impact factor: 5.386

2.  General practitioners' reflections on referring: an asymmetric or non-dialogical process?

Authors:  Olav Thorsen; Miriam Hartveit; Anders Baerheim
Journal:  Scand J Prim Health Care       Date:  2012-10-10       Impact factor: 2.581

3.  How does the thought of cancer arise in a general practice consultation? Interviews with GPs.

Authors:  May-Lill Johansen; Knut Arne Holtedahl; Carl Edvard Rudebeck
Journal:  Scand J Prim Health Care       Date:  2012-07-02       Impact factor: 2.581

4.  Primary medical care continuity and patient mortality: a systematic review.

Authors:  Richard Baker; George K Freeman; Jeannie L Haggerty; M John Bankart; Keith H Nockels
Journal:  Br J Gen Pract       Date:  2020-08-27       Impact factor: 5.386

5.  Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK.

Authors:  Katriina L Whitaker; Una Macleod; Kelly Winstanley; Suzanne E Scott; Jane Wardle
Journal:  Br J Gen Pract       Date:  2015-02       Impact factor: 5.386

6.  How might healthcare systems influence speed of cancer diagnosis: a narrative review.

Authors:  Sally Brown; Michele Castelli; David J Hunter; Jonathan Erskine; Peter Vedsted; Catherine Foot; Greg Rubin
Journal:  Soc Sci Med       Date:  2014-06-24       Impact factor: 4.634

Review 7.  Understanding missed opportunities for more timely diagnosis of cancer in symptomatic patients after presentation.

Authors:  G Lyratzopoulos; P Vedsted; H Singh
Journal:  Br J Cancer       Date:  2015-03-31       Impact factor: 7.640

8.  Health-care delay in malignant melanoma: various pathways to diagnosis and treatment.

Authors:  Senada Hajdarevic; Asa Hörnsten; Elisabet Sundbom; Ulf Isaksson; Marcus Schmitt-Egenolf
Journal:  Dermatol Res Pract       Date:  2014-01-05

9.  Estimates of delays in diagnosis of cervical cancer in Nepal.

Authors:  Deepak Gyenwali; Gita Khanal; Rajan Paudel; Archana Amatya; Jitendra Pariyar; Sharad Raj Onta
Journal:  BMC Womens Health       Date:  2014-02-17       Impact factor: 2.809

10.  Patient delay in cancer diagnosis: what do we really mean and can we be more specific?

Authors:  Christina Mary Dobson; Andrew James Russell; Greg Paul Rubin
Journal:  BMC Health Serv Res       Date:  2014-09-12       Impact factor: 2.655

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