Table 5 Areas that need improvement to enhance the overall perception of healthcare delivery from the voice of participants (final component of global perception of effective coverage in the Tanahashi model).
Area to improve | Quotes |
|---|---|
1) Human relations: Vocation, good treatment, respect, humanization | 'It surprises me here (in the public system) there is not that vocation with patients and even more so with one who has cancer, there has to be delicacy and special treatment, and that does not exist. Not all those who work with the cancer patient have that treatment' P18_M_Spu 'The team that works with cancer patients must be doubly well chosen. Because of all my visits to the clinic, on several occasions to insert the catheter, then to remove it due to the thrombosis and then to put it back in and what do I know, each time it is a ward, it is a process…I would tell you that 93% I found smiling, problem- solving… friendly people, which generally not everyone always has to be like that' P7_M_SPr 'Yes, I had to fight for my needs. And for the attention. For better treatment in the hospital, better treatment for one' P10_M_Spu 'In the hospital there is a lack of humanization, here they don’t talk to the patient' M5, public 'They really, really value that their doctor is empathetic, loving, that he takes the time to explain, to be able to clarify doubts, and that they feel that he is someone who is committed to them and that he is not someone who fights. The patient says that they are there writing the file and that they do not see them, or that they are there writing the paper file, I also think that patients value a lot, the human quality of their treating doctor' M3, private |
2) Communication | 'I think it is communication, it is what is most difficult. Because sometimes institutions can be super agile in terms of opportunity and quality and so on, but communication is so individual and so dependent on the person and the moment the person is at. Because if a day comes with many personal complexities, it affects the ability to communicate, then it is very variable individually and with different patients, as well as within the institution with different professionals. Not everyone has the same capabilities or the same ability, or they are not in the same conditions to be able to communicate well. M4, private |
3) Prioritize care for cancer patients in the public and private system | 'The quality has been generally good, but as I repeat, there is a lack of attention, more attention, more priority to cancer patients' P5_M_Spu 'Difficulty…look, I would say going to Isapre, to the office to do the paperwork, or a lot of delay. It was a long wait, two, three, four hours of waiting. A couple of times I just said, I’m an oncology patient, can you get me a special number…I don’t know' P8_M_SPr |
4) Continuity of health care | 'As I told you, the information, the treatment and the follow-up… see how the family is doing. It is true that they have 15–20 min, but they can make an appointment with your family and say, look, this and that are going to happen to your wife and she needs this and that… As I say, they should do more of that in hospitals, In private clinics, why are we going to say if we know that the treatment is very different. But what it is here in public health, there must be more humanity. There must be more, because the one who comes to the hospital is because he has a serious illness, because he is depressed, he is with… what he has the most is terror because as we are human beings, we all fear death. Even though we are old, we are afraid of dying.' P10_M_Spu 'But for the public health system, the follow-ups should be done, in our case, by the clinics, not the cancer centres. We have to work on this, so that the monitoring of our patients or of the patients of all the hospitals is followed in their offices. But for that we have to have a more connected network. A unique electronic token. 'That would change the history of medicine in Chile instantly.' M2, private |
5) Oncology training | '…more knowledge of the area that is not oncological, that is, the… having a more humane treatment, listening to each other' P15_M_SPr 'When you talk to colleagues, there is a lot of ignorance regarding the specialty. There is a lot of ignorance regarding treatments, how oncology has been advancing. Which is super strange, that undergraduate and graduate schools do not encourage it so much today, because it is an important cause of mortality in our country, it is the first in some regions' M1, public |
6) Family health care | 'Knowledge also at the level of, uh… children, support for the family, cachai? For example, we found ourselves, thanks to the psychologist who is seeing Anto, because she has been the one who has been with a psychologist since the departure of the process' P15_M_SPr 'As I told you, the information, the treatment and the follow-up… see how the family is doing. It is true that they have 15–20 min, but they can make an appointment with your family and say, look, this and that are going to happen to your wife and she needs this and that… As I say, hospitals should do more of that.' P10_M_Spu |
7) Administrative staff training | 'There is a lot of lack of training in the administrative line, especially when people are like me with breast cancer, that, there are some times that, that are in accordance with the Ges, or, or, that you are against time, You can’t be like one, a patient who can wait, I don’t know, I say, a gallbladder for seven months, although I know that people with gallbladders suffer a lot. But I am against a time to start treatment' P16_M_Spu |
8) Improve public system times | 'The public system is delayed, it is the reality, although it is true until the GES, clearly, there is the GES and it has its times, but what happens is that the public system still does not understand or the doctors themselves do not understand, that when they tell you that you have cancer, in my case, I have four or five relatives who have died of cancer, so when we found that I also had cancer, it was OMG!. No one understands it, that one enters into desperation, that is not understood, so no, the biopsy has to wait, I don’t know twenty-something days, 30 days, but in private clinic that doesn’t take long. It should be the same as the private system.' P18_M_Spu 'I think we have to improve the times, the access to biopsies of the people who do it, the people who do biopsy or the biopsy machines, they require human resources, people who know how to do that and that is not everywhere, This can produce a waiting list or congestion in some public hospitals.'M2, private 'To get to the specialist with the result of the biopsy, I believe that in a public hospital, it can easily take 2 or 3 months from when the patient suspects he has cancer until he has the biopsy and reaches the specialist, From the moment the patient notices something to when he arrives with…doctor, I have this biopsy that says cancer. Easy two-three months. And in the private system, I think it is more or less a month' M3, private |
9) Systems to ensure attendance at follow-up controls | 'In the foundation, the controls are super rigorous, one has to go, but it also depends a lot on oneself, because if I don’t go, no one called me to tell me, oh, you missed the control, no. Maybe too, that would be a point that… that, I don’t know how to say it, that it is difficult to be called po’, to remind you, but, but of course, that is, if there is a patient who is absent for a long time, there should still be a rescue of patients, because for some reason he is not going and it is important so that he does not return to… the disease' P19_M_Spu 'There is no active person who says, damn, Mrs. xxxx it was your turn to check up today and she didn’t come, let’s call her on the phone, damn… and let’s reschedule her time. No, if the patient did not go to the appointment, she will have to worry about requesting a new appointment' M3, private. |
