<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_sjph-2022-0007_s_006">
<h3>Introduction</h3>
<p>Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners’ (PCPs’) clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania).</p></sec>
<sec id="j_sjph-2022-0007_s_007">
<h3>Methods</h3>
<p>PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors. Participants were also asked to make clinical decisions in a vignette of a patient with possible lung cancer.</p></sec>
<sec id="j_sjph-2022-0007_s_008">
<h3>Results</h3>
<p>The survey was completed by 475 PCPs. There were significant national differences in PCPs’ direct access to investigations, particularly to advanced imaging. PCPs from Bulgaria, Greece, and Romania were more likely to organise relevant investigations. The highest specialist referral rates were in Bulgaria and Romania. PCPs in Bulgaria were less likely to have access to clinical guidelines, and PCPs from Slovenia and Croatia were more likely to have access to a cancer fast-track specialist appointment system. The PCPs’ country had a significant effect on their likelihood of investigating or referring the patient.</p></sec>
<sec id="j_sjph-2022-0007_s_009">
<h3>Conclusions</h3>
<p>There are large differences between Balkan region countries in PCPs’ levels of direct access to investigations. When faced with a vignette of a patient with the possibility of having lung cancer, their investigation and referral rates vary considerably. To reduce diagnostic delay in lung cancer, direct PCP access to advanced imaging, availability of relevant clinical guidelines, and fast-track referral systems are needed.</p></sec></abstract>

Introduction
Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners’ (PCPs’) clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania).

Methods
PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors. Participants were also asked to make clinical decisions in a vignette of a patient with possible lung cancer.

Results
The survey was completed by 475 PCPs. There were significant national differences in PCPs’ direct access to investigations, particularly to advanced imaging. PCPs from Bulgaria, Greece, and Romania were more likely to organise relevant investigations. The highest specialist referral rates were in Bulgaria and Romania. PCPs in Bulgaria were less likely to have access to clinical guidelines, and PCPs from Slovenia and Croatia were more likely to have access to a cancer fast-track specialist appointment system. The PCPs’ country had a significant effect on their likelihood of investigating or referring the patient.

Conclusions
There are large differences between Balkan region countries in PCPs’ levels of direct access to investigations. When faced with a vignette of a patient with the possibility of having lung cancer, their investigation and referral rates vary considerably. To reduce diagnostic delay in lung cancer, direct PCP access to advanced imaging, availability of relevant clinical guidelines, and fast-track referral systems are needed.

Primary care system factors and clinical decision-making in patients that could have lung cancer: A vignette study in five balkan region countries

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Dejavniki primarnega zdravstva in klinično odločanje pri bolnikih, ki bi lahko imeli pljučnega raka: Raziskava s pomočjo vinjete v petih državah balkanske regije

Introduction
Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors...

Primary care system factors and clinical decision-making in patients that could have lung cancer: A vignette study in five balkan region countries

Article Category: Original scientific article

Data publikacji: 03 sty 2022

Zakres stron: 40 - 47

Otrzymano: 21 gru 2020

Przyjęty: 19 lis 2021

DOI: https://doi.org/10.2478/sjph-2022-0007

Słowa kluczowe
lung cancer, primary care, gatekeeping, early diagnosis

© 2022 National Institute of Public Health, Slovenia, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Primary care system factors and clinical decision-making in patients that could have lung cancer: A vignette study in five balkan region countries

Article Category: Original scientific article

Data publikacji: 03 sty 2022

Zakres stron: 40 - 47

Otrzymano: 21 gru 2020

Przyjęty: 19 lis 2021

DOI: https://doi.org/10.2478/sjph-2022-0007

Słowa kluczowelung cancer, primary care, gatekeeping, early diagnosis

© 2022 National Institute of Public Health, Slovenia, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Słowa kluczowe
lung cancer, primary care, gatekeeping, early diagnosis