Incorporation of gastric cancer to the ges: impact on the access to and the opportunity for surgical therapy at a SSMS HOSPITAL

Abstract

Gastric cancer is a pathology with a high prevalence and mortality rate  in Chile.  In view of the latter, such condition was incorporated to the explicit health guarantees program (GES) from July 1st 2006.  The purpose of the present study is to assess the impact of such program on the access to a timely diagnosis and treatment for such neoplasia.  This was achieved through the analysis of secondary data obtained from medical records, Upper GI Endoscopy and Biopsy reports, from 76 patients having undergone surgery for gastric cancer between July 1st 2003 and June 30th 2007 at a SSMS hospital.

The results showed that, against the expected, there were no significant changes in the number of operated patients.  In fact, compared to previous years, the number of gastrectomies for Gastric Cancer was smaller, with 12 procedures carried out during the Post-AUGE period, as compared to 16,33 gastrectomies/year during the previous period.  This represents a decrease in 26,53%, without significant proportional changes per patient gender and age.  As for the explicit guarantees, there was non-fulfillment of the assured deadlines in at least 2 of the 12 patients with a diagnosis of gastric cancer and an indication for surgical therapy.  The reasons why the AUGE outcomes did not result in a greater number of surgeries and in a total fulfillment of the guaranteed deadlines are manifold and not necessarily mutually excluding, and should be subject of analysis in further studies.