Breast Cancer in Limited-Resource Countries: Health Care Systems and Public Policy

作者：Benjamin O. Anderson, Cheng Har Yip, Scott David Ramsey, Rafael Bengoa, Susan Braun, Margaret I. Fitch, Martijn T. Groot, H Sancho-Garnier, Vivien Davis Tsu, for the Global Summit Health Care Systems and Public Policy Panel · 发表于：The Breast Journal · 年份：2006 · DOI：10.1111/j.1075-122x.2006.00203.x · 被引用次数：172 · 研究领域：Global Cancer Incidence and Screening、Colorectal Cancer Screening and Detection、Economic and Financial Impacts of Cancer

As the largest cancer killer of women around the globe, breast cancer adversely impacts countries at all levels of economic development. Despite major advances in the early detection, diagnosis, and treatment of breast cancer, health care ministries face multitiered challenges to create and support health care programs that can improve breast cancer outcomes. In addition to the financial and organizational problems inherent in any health care system, breast health programs are hindered by a lack of recognition of cancer as a public health priority, trained health care personnel shortages and migration, public and health care provider educational deficits, and social barriers that impede patient entry into early detection and cancer treatment programs. No perfect health care system exists, even in the wealthiest countries. Based on inevitable economic and practical constraints, all health care systems are compelled to make trade-offs among four factors: access to care, scope of service, quality of care, and cost containment. Given these trade-offs, guidelines can define stratified approaches by which economically realistic incremental improvements can be sequentially implemented within the context of resource constraints to improve breast health care. Disease-specific "vertical" programs warrant "horizontal" integration with existing health care systems in limited-resource countries. The Breast Health Global Initiative (BHGI) Health Care Systems and Public Policy Panel defined...