Retrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients

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dc.article.numbere3033
dc.catalogadorgrr
dc.contributor.authorAcevedo, Johanna
dc.contributor.authorIp, Teresa
dc.contributor.authorMaureira, Lea
dc.contributor.authorSánchez Rojel, César Giovanni
dc.contributor.authorOsorio, Claudia
dc.contributor.authorCarvajal, Claudia
dc.contributor.authorAraos, Rafael
dc.contributor.authorLetelier, Hernan
dc.contributor.authorAcevedo, Francisco
dc.contributor.authorMerino, Tomas
dc.date.accessioned2025-04-24T20:06:40Z
dc.date.available2025-04-24T20:06:40Z
dc.date.issued2025
dc.description.abstractBreast cancer is the most common malignancy in the Americas, and the second leading cause of cancer death. Disparities in the time to treatment can significantly impact patient outcomes and typically affect lower socioeconomic individuals and/or ethnic minorities. Our study sought to evaluate disparities in time to treatment at three health institutions in Chile according to their type of health insurance (public or private). METHODS Our study analyzed a database of breast cancer patients diagnosed between 2017 and 2018. Analyses included descriptive statistics and a linear regression model that incorporated clinical and demographic variables. Additionally, using a proportional risks model, we analyzed the association between clinical variables and mortality. RESULTS Public health insurance (National Health Fund, FONASA) was associated with longer time-to-treatment and extended treatment times versus private health insurance (Social Security Institutions, ISAPRE; p < 0.0001). As expected, a more advanced stage at diagnosis was associated with lower survival. Our proportional risks model found that age was a predictor of breast cancer mortality in stage II patients. Also, total treatment time significantly increased the risk of breast cancer mortality in stage I patients. Conversely, total treatment time did not affect mortality on stages II or III. CONCLUSIONS We found significant disparities in the time to treatment of Chilean breast cancer patients using FONASA versus private ISAPRE. FONASA patients experience delays in the initiation of treatment and longer total treatment times compared to their private insurance counterparts. Finally, longer time-to-treatment was associated with more advanced stages and increased mortality.
dc.fechaingreso.objetodigital2025-04-24
dc.format.extent10 páginas
dc.fuente.origenORCID
dc.identifier.doi10.5867/medwave.2025.03.3033
dc.identifier.issn0717-6384
dc.identifier.pubmedid40209172
dc.identifier.urihttps://doi.org/10.5867/medwave.2025.03.3033
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103447
dc.information.autorucEscuela de Medicina; Acevedo Claros, Francisco Nicolas; 0000-0003-3482-7746; 119540
dc.information.autorucEscuela de Medicina; Sánchez Rojel, César Giovanni; 0000-0002-2920-108X; 135644
dc.issue.numero3
dc.language.isoen
dc.nota.accesocontenido completo
dc.rightsacceso abierto
dc.rights.licenseBY-NC-SA 4.0 Atribución/Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
dc.subjectBreast cancer
dc.subjectHealthcare disparities
dc.subjectPublic and private healthcare systems
dc.subjectTime-to-treatment intervals
dc.subjectMortality
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRetrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients
dc.typeartículo
dc.volumen25
sipa.codpersvinculados119540
sipa.codpersvinculados135644
sipa.trazabilidadORCID;2025-04-21
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