A systematic review of geographical variation in access to chemotherapy
| العنوان: | A systematic review of geographical variation in access to chemotherapy |
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| المؤلفون: | Charlotte Chamberlain, William Hollingworth, Jenny L Donovan, Amanda Owen-Smith |
| المصدر: | BMC Cancer Chamberlain, C, Owen-Smith, A, Donovan, J & Hollingworth, W 2015, ' A systematic review of geographical variation in access to chemotherapy ', BMC Cancer, vol. 16, no. 1 . https://doi.org/10.1186/s12885-015-2026-y8433826891537643Test |
| بيانات النشر: | BioMed Central, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | 0301 basic medicine, Cancer Research, Cost-Benefit Analysis, MEDLINE, Variation, Antineoplastic Agents, 03 medical and health sciences, 0302 clinical medicine, Rurality, Neoplasms, Health care, medicine, Genetics, Chemotherapy, Humans, Health inequalities, Cancer, Receipt, Geography, business.industry, Drugs, medicine.disease, United Kingdom, Study heterogeneity, 030104 developmental biology, Systematic review, Oncology, Centre for Surgical Research, 030220 oncology & carcinogenesis, Meta-analysis, business, Delivery of Health Care, Demography, Research Article |
| الوصف: | Background Rising cancer incidence, the cost of cancer pharmaceuticals and the introduction of the Cancer Drugs Fund in England, but not other United Kingdom(UK) countries means evidence of ‘postcode prescribing’ in cancer is important. There have been no systematic reviews considering access to cancer drugs by geographical characteristics in the UK. Methods Studies describing receipt of cancer drugs, according to healthcare boundaries (e.g. cancer network [UK]) were identified through a systematic search of electronic databases and grey literature. Due to study heterogeneity a meta-analysis was not possible and a narrative synthesis was performed. Results 8,780 unique studies were identified and twenty-six included following a systematic search last updated in 2015. The majority of papers demonstrated substantial variability in the likelihood of receiving chemotherapy between hospitals, health authorities, cancer networks and UK countries (England and Wales). After case-mix adjustment, there was up to a 4–5 fold difference in chemotherapy utilisation between the highest and lowest prescribing cancer networks. There was no strong evidence that rurality or distance travelled were associated with the likelihood of receiving chemotherapy and conflicting evidence for an effect of travel time. Conclusions Considerable variation in chemotherapy prescribing between healthcare boundaries has been identified. The absence of associations with natural geographical characteristics (e.g. rurality) and receipt of chemotherapy suggests that local treatment habits, capacity and policy are more influential. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-2026-y) contains supplementary material, which is available to authorized users. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1471-2407 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::28e16928ebbd8636e9991af15ec37a4cTest http://europepmc.org/articles/PMC4697930Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....28e16928ebbd8636e9991af15ec37a4c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712407 |
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