Objectives: To evaluate the impact of more open access to health services by Thailand's universal health coverage (UHC) on diagnostic delay of oral squamous cell carcinomas (OSCC) by comparing results with our previous study prior to the UHC. Reasons for delay in attending healthcare professional (HCP) consultation were also investigated.
Methods: A structure questionnaire was employed to interview 154 OSCC consecutive patients. Variables were included for Cox proportional regression models to conclude the hazard ratio of each delay.
Results: Regarding patient delay, those who had more than 12-year education showed less delay (HR 0.46, 95% CI: 0.21-1.01) while longer delay was found in farmers (HR 1.49, 95% CI: 1.05-2.11). Compared with the previous study, there was no association between herbal medication and patient delay, herbal medication and total delay, nor religion and total delay. Professional delay showed no association with any variable. Only half of the patients received initial proper HCP management in both studies. Patient delay was mostly (89.9%) due to unawareness of the lesion severity.
Conclusions: Open access to the healthcare system had an influence on diagnostic delay. Public education and precise clinical acumen by HCPs in OSCC diagnosis are needed for early detection.
Keywords: Thailand; diagnostic delay; healthcare access; oral cancer; universal health coverage.
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