Experience in the continuous care of pancreatic cancer at a high-complexity hospital in Bogota

Abstract

Objective To describe and evaluate the care pathway of patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) at Hospital Universitario San Ignacio (HUSI), between 2017-2023. Methods An analytical, observational, retrospective cohort study was conducted. The study population included patients over 18 years of age with histopathological confirmed diagnosis of PDAC at HUSI. Data were collected on sociodemographics, clinical characteristics, morbidity, mortality, and variables related to the continuum of care. Descriptive and bivariate analyses were performed using Chi-square and Kruskal-Wallis tests. Results A total of 105 patients were included in the study. The majority (90.5%) received the proposed treatment, with palliative care being the most frequent approach (73.3%). A high prevalence of care fragmentation (CF) was observed in 41.9% of patients. CF was significantly associated with affiliation to a specific Health Benefits Plan Administrator (EAPB), having the intention of curative treatment, and presenting with early-stage pathology. The time interval between surgery and adjuvant therapy was longer in patients with CF. Conclusions The study identifies a pattern of late diagnosis of PDAC, which frequently leads to an initial palliative treatment approach. There was a high prevalence of CF which, coupled with late diagnosis, suggests the need to improve coordination of care. A significant association between CF and factors such as affiliation to particular EAPBs, the intention to receive curative treatment, and early-stage pathology was identified, highlighting the importance of targeted interventions aimed at optimizing access and continuity of care in this population.