Healthcare stakeholders' perspectives on coordinating cancer diagnosis in Chile, Colombia, and Ecuador


Por: Oturai O, Mogollón-Pérez AS, Eguiguren P, Torres Castillo AL, Peralta-Chiriboga AA, Rubio-Valera M, Dias S and Jervelund SS

Publicada: 1 ene 2026 Ahead of Print: 13 ene 2026
Resumen:
Objective. To explore healthcare stakeholders' experiences of care coordination during cancer diagnosis in Chile, Colombia, and Ecuador, including how these experiences are influenced by factors related to the countries' public subsystems. Methods. A qualitative study was conducted based on 115 semi-structured interviews with healthcare professionals and administrative personnel in both primary care (n = 40) and secondary/tertiary care (n = 46) as well as managers and policymakers (n = 29). Thematic analysis, guided by a care coordination framework, was performed first per country and then across countries. Results. The analysis points to limited transfer of clinical information causing repeated tests as well as poor clinical management coordination in terms of delayed referrals from primary care and restricted access to specialized care, altogether contributing to diagnostic delays. Self-reinforcing loops of barriers for care coordination included fragmented clinical information systems, poor skills and training among healthcare professionals, as well as insufficient diagnostic equipment in all three study countries, scarcity of specialized healthcare professionals and functioning of the prioritization system for certain cancers in Chile, and working conditions and insurance companies' management of care in Colombia. Informal communication strategies and personal networks emerged as adaptive responses to these challenges, facilitating coordination in some cases but also risking data security and consistency in care. Conclusions. The study highlights the urgent need for political prioritization of cancer care coordination, including investments in unified clinical record systems, training of healthcare professionals, and diagnostic infrastructure. It also emphasizes the importance of recognizing healthcare stakeholders' responses to barriers.

Filiaciones:
Oturai O:
 University of Copenhagen Copenhagen Denmark University of Copenhagen, Copenhagen, Denmark

Mogollón-Pérez AS:
 Universidad del Rosario Bogotá Colombia Universidad del Rosario, Bogotá, Colombia

Eguiguren P:
 Universidad de Chile Santiago Chile Universidad de Chile, Santiago, Chile

Torres Castillo AL:
 Pontificia Universidad Católica del Ecuador Quito Ecuador Pontificia Universidad Católica del Ecuador, Quito, Ecuador

Peralta-Chiriboga AA:
 Pontificia Universidad Católica del Ecuador Quito Ecuador Pontificia Universidad Católica del Ecuador, Quito, Ecuador

Rubio-Valera M:
 Parc Sanitari Sant Joan de Déu Barcelona Spain Parc Sanitari Sant Joan de Déu, Barcelona, Spain

Dias S:
 NOVA University Lisbon Lisbon Portugal NOVA University Lisbon, Lisbon, Portugal

Jervelund SS:
 University of Copenhagen Copenhagen Denmark University of Copenhagen, Copenhagen, Denmark
ISSN: 10204989





REVISTA PANAMERICANA DE SALUD PUBLICA-PAN AMERICAN JOURNAL OF PUBLIC HEALTH
Editorial
PAN AMER HEALTH ORGANIZATION, 525 23RD ST NW, WASHINGTON, DC 20037, Estados Unidos America
Tipo de documento: Article
Volumen: 50 Número:
Páginas:
WOS Id: 001718370300005
ID de PubMed: 41536934
imagen Green Submitted, gold

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