TY - JOUR
T1 - Impact of Physician Dual Practices on a Pediatric-Oncology Outreach-Programhowever
AU - Olbara, Gilbert
AU - Handayani, Krisna
AU - Hoogland, Iris
AU - Widjajanto, Pudjo
AU - Njuguna, Festus Muigai
AU - Sitaresmi, Mei
AU - Kaspers, Gertjan
AU - Mostert, Saskia
N1 - Funding Information: The authors thank the Foundation World Child Cancer NL and AFAS Foundation for their support. Publisher Copyright: © (2023), (Asian Pacific Organization for Cancer Prevention). All Rights Reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - OBJECTIVE: Physician dual practices (PDP) can be defined as 'doctors combining clinical work in public and private health-sector.' This study explores the impact of PDP on a long-term pediatric-oncology outreach-program between large referral hospitals in the Netherlands, Indonesia and Kenya. METHODS: This cross-sectional descriptive study used a self-administered semi-structured survey. The most senior doctor from each partner site was interviewed in June 2022. The survey contained 70 closed-ended and 7 open-ended questions and took 30-45 minutes to complete. Closed-ended questions were evaluated on 2-5 point rating scales. Informed consent was acquired and respondents endorsed the final report. RESULTS: In the Netherlands an estimated 0-20% of senior doctors combine work in public and private-sector, while 60-80% do so in Indonesia and Kenya according to the respondents. In Indonesia and Kenya, most of doctors are involved in PDP to augment low government salaries. Impact of PDP on pediatric-oncology care is minimal in the Netherlands, but detrimental in Indonesia and Kenya: shortage of experienced doctors, limited supervision of junior staff, slow diagnostics and delays in chemotherapy administration ultimately lead to undermining of the quality of care and adverse patient outcomes. CONCLUSIONS: PDP adversely impact patient care at the Indonesian and Kenyan partner sites of a pediatric-oncology outreach-program. Strategies addressing PDP in resource-poor settings are required to improve treatment outcomes and survival of children with cancer.
AB - OBJECTIVE: Physician dual practices (PDP) can be defined as 'doctors combining clinical work in public and private health-sector.' This study explores the impact of PDP on a long-term pediatric-oncology outreach-program between large referral hospitals in the Netherlands, Indonesia and Kenya. METHODS: This cross-sectional descriptive study used a self-administered semi-structured survey. The most senior doctor from each partner site was interviewed in June 2022. The survey contained 70 closed-ended and 7 open-ended questions and took 30-45 minutes to complete. Closed-ended questions were evaluated on 2-5 point rating scales. Informed consent was acquired and respondents endorsed the final report. RESULTS: In the Netherlands an estimated 0-20% of senior doctors combine work in public and private-sector, while 60-80% do so in Indonesia and Kenya according to the respondents. In Indonesia and Kenya, most of doctors are involved in PDP to augment low government salaries. Impact of PDP on pediatric-oncology care is minimal in the Netherlands, but detrimental in Indonesia and Kenya: shortage of experienced doctors, limited supervision of junior staff, slow diagnostics and delays in chemotherapy administration ultimately lead to undermining of the quality of care and adverse patient outcomes. CONCLUSIONS: PDP adversely impact patient care at the Indonesian and Kenyan partner sites of a pediatric-oncology outreach-program. Strategies addressing PDP in resource-poor settings are required to improve treatment outcomes and survival of children with cancer.
KW - Physician dual practices
KW - childhood cancer
KW - outreach
KW - program
UR - http://www.scopus.com/inward/record.url?scp=85168956479&partnerID=8YFLogxK
U2 - https://doi.org/10.31557/APJCP.2023.24.8.2647
DO - https://doi.org/10.31557/APJCP.2023.24.8.2647
M3 - Article
C2 - 37642050
SN - 2476-762X
VL - 24
SP - 2647
EP - 2651
JO - Asian Pacific journal of cancer prevention : APJCP
JF - Asian Pacific journal of cancer prevention : APJCP
IS - 8
ER -