The choice of medical facility and associated factors among Chinese advanced colorectal cancer patients: a cross-sectional multi-center study
Wang, Xiao-Yang1; Wang, Wen-Jun2; Zhao, Yu-Qian3; Liu, Yin1; Wang, Xiao-Hui4; Du, Ling-Bin5; Duan, Shuang-Xia6; Zhang, Xi7; Yu, Yan-Qin8; Ma, Li9; Liu, Yun-Yong10; Huang, Juan-Xiu11; Cao, Ji12; Li, Li13; Gu, Xiao-Fen14; Fan, Yan-Ping15; Feng, Chang-Yan16; Lian, Xue-Mei17; Du, Jing-Chang18; Zhang, Jian-Gong1; Qiao, You-Lin1,19
Corresponding AuthorZhang, Jian-Gong(zhangjg@zzu.edu.cn) ; Qiao, You-Lin(qiaoy@cicams.ac.cn)
AbstractBackground: Colorectal cancer (CRC) poses a significant public health burden worldwide. The investigation of the choice of medical facility among CRC patients is helpful for understanding access to health services and improving quality of oncology services to optimize health outcomes. However, there are limited studies on the topic. The objective of this study was to investigate the choice of medical facility and its associated factors among advanced CRC patients. Methods: This cross-sectional multi-center study included a total of 4,589 individuals with advanced CRC from 19 hospitals in 7 geographic regions in China. Participants were recruited by multi-stage stratified sampling. In the first stage, two cities in each geographic region were selected through simple randomsampling. In the second stage, one tertiary cancer hospital and/or one general hospital were selected in each city. Data on medical experience and demographics were collected via a questionnaire during face-toface interviews. Explanatory variables were selected based on the Andersen behavioral model. Multinomial logistic regression analyses were performed to explore the factors associated with the level of medical facility for the first treatment. Results: Hospitals at the prefecture level were the most common medical facility sought by advanced CRC patients for initial medical care (44.9%), the first definite diagnosis (46.3%), the first treatment (39.5%), and regular follow-up (38.9%). However, the first priority was changed to hospitals at the national level for the second treatment (38.0%) and after recurrence and metastasis (45.9%). Female {odds ratios (ORs) ranged from 1.31 [95% confidence interval (CI): 1.01-1.71] to 1.41 [95% CI: 1.07-1.87]} and relatively welleducated individuals [ORs ranged from 1.74 (95% CI: 1.20-2.53) to 7.26 (95% CI: 4.18-12.60)] preferred to seek higher-level health facilities. Individuals with metastatic CRC at diagnosis were more likely to visit hospitals in provincial capitals versus hospitals at the county level (OR =1.68, 95% CI: 1.27-2.22). Individuals with "good" health-related quality of life (HRQOL) (OR =0.63, 95% CI: 0.49-0.81) were less likely to seek hospitals at the prefecture level compared with hospitals at the county level. Conclusions: There is a need to improve the oncology services for CRC patients, including the optimization of referral reform policy and the promotion of quality of primary healthcare service. The results may provide evidence to fill the policy-implementation gap and potentially contribute to the improvement of the efficiency of the healthcare system.
KeywordColorectal cancer (CRC) healthcare seeking medical facility associated factors
Indexed BySCI
Funding ProjectBeijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
Funding OrganizationBeijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
WOS Research AreaOncology ; Research & Experimental Medicine
WOS SubjectOncology ; Medicine, Research & Experimental
WOS IDWOS:000777858400001
PublisherAME PUBL CO
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Document Type期刊论文
Corresponding AuthorZhang, Jian-Gong; Qiao, You-Lin
Affiliation1.Zhengzhou Univ, Affiliated Canc Hosp, Henan Int Joint Lab Canc Prevent,Dept Canc Epidem, Henan Canc Hosp,Henan Engn Res Ctr Canc Prevent &, Zhengzhou, Peoples R China
2.Jining Med Univ, Sch Nursing, Jining, Peoples R China
3.Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Sch Med, Chengdu, Peoples R China
4.Gansu Prov Canc Hosp, Dept Publ Hlth, Lanzhou, Peoples R China
5.Univ Chinese Acad Sci, Zhejiang Canc Hosp, Dept Canc Prevent, Canc Hosp, Hangzhou, Peoples R China
6.Xinxiang Cent Hosp, Dept Prevent Hlth, Xinxiang, Henan, Peoples R China
7.Peking Univ Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Beijing Off Canc Prevent & Control, Minist Educ Beijing, Beijing, Peoples R China
8.Baotou Med Coll, Clin Epidemiol Res Ctr, Dept Publ Hlth & Prevent Med, Baotou, Peoples R China
9.Dalian Med Univ, Publ Hlth Sch, Dalian, Peoples R China
10.China Med Univ, Liaoning Canc Hosp & Inst, Liaoning Off Canc Control & Res, Canc Hosp, Shenyang, Peoples R China
11.Wuzhou Red Cross Hosp, Dept Gastroenterol, Wuzhou, Peoples R China
12.Guangxi Med Univ, Dept Canc Prevent & Control Off, Affiliated Hosp 1, Nanning, Peoples R China
13.Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China
14.Xinjiang Med Univ, Affiliated Tumor Hosp, Dept Student Affairs, Urumqi, Peoples R China
15.Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Canc Ctr, Guangzhou, Peoples R China
16.Chongqing Univ Canc Hosp, Chongqing Key Lab Translat Res Canc Metastasis &, Chongqing, Peoples R China
17.Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China
18.Chengdu Med Coll, Sch Publ Hlth, Chengdu, Peoples R China
19.Chinese Acad Med Sci & Peking Union Med Coll, Ctr Global Hlth, Sch Populat Med & Publ Hlth, Beijing 100005, Peoples R China
Recommended Citation
GB/T 7714
Wang, Xiao-Yang,Wang, Wen-Jun,Zhao, Yu-Qian,et al. The choice of medical facility and associated factors among Chinese advanced colorectal cancer patients: a cross-sectional multi-center study[J]. ANNALS OF TRANSLATIONAL MEDICINE,2022.
APA Wang, Xiao-Yang.,Wang, Wen-Jun.,Zhao, Yu-Qian.,Liu, Yin.,Wang, Xiao-Hui.,...&Qiao, You-Lin.(2022).The choice of medical facility and associated factors among Chinese advanced colorectal cancer patients: a cross-sectional multi-center study.ANNALS OF TRANSLATIONAL MEDICINE.
MLA Wang, Xiao-Yang,et al."The choice of medical facility and associated factors among Chinese advanced colorectal cancer patients: a cross-sectional multi-center study".ANNALS OF TRANSLATIONAL MEDICINE (2022).
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