Determinantes sociales y clínicos del uso de servicios sanitarios en mujeres con cáncer de mama (Cohorte DAMA)

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• dc.contributor.author Puigpinós i Riera, Rosa
• dc.contributor.author Castillo Gómez, Adán
• dc.contributor.author Romero, Anabel
• dc.contributor.author Aller, Marta-Beatriz
• dc.contributor.author Castells, Xavier
• dc.contributor.author Sala Serra, Maria
• dc.contributor.author Grupo Cohort Dama
• dc.date.accessioned 2019-07-24T07:37:47Z
• dc.date.available 2019-07-24T07:37:47Z
• dc.date.issued 2019
• dc.description Data de publicació electrónica: 18-07-2018
• dc.description.abstract 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Puigpinós-Riera R, Castillo Gómez A, Romero Morales A, Aller M, Castells X, Sala M. Determinantes sociales y clínicos del uso de servicios sanitarios en mujeres con cáncer de mama (Cohorte DAMA). Gac Sanit.2019 Sep - Oct;33(5):434-441. DOI: 10.1016/j.gaceta.2018.04.014
• dc.identifier.doi http://dx.doi.org/10.1016/j.gaceta.2018.04.014
• dc.identifier.issn 0213-9111
• dc.identifier.uri http://hdl.handle.net/10230/42154
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights 0213-9111/© 2018 SESPAS. Publicado por Elsevier España, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Atención primaria
• dc.subject.keyword Breast cancer survivors
• dc.subject.keyword Clinical determinants
• dc.subject.keyword Determinantes
• dc.subject.keyword Emergency departments
• dc.subject.keyword Hospital admissions
• dc.subject.keyword Ingresos hospitalarios
• dc.subject.keyword Primary care
• dc.subject.keyword Social determinants
• dc.subject.keyword Supervivientes de cáncer de mama
• dc.subject.keyword Urgencias
• dc.subject.keyword Use of health services
• dc.subject.keyword Uso de servicios sanitarios
• dc.title Determinantes sociales y clínicos del uso de servicios sanitarios en mujeres con cáncer de mama (Cohorte DAMA)
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion