title: Insurance status and time to completion of surgery for breast cancer.
abstract: BACKGROUND
  The aim of this study was to compare the time to re-operation, following inadequate loco-regional surgery for breast cancer, between the public and private sectors of the Sunshine Coast region.
  
  
  METHODS
  A retrospective review was performed of the medical records of all female patients undergoing guide wire-localized, breast-conserving surgery at Nambour General Hospital and in the local private sector from January 2009 until April 2010. The dates of initial consultation, operation, post-operative consultation and any subsequent reoperation were recorded.
  
  
  RESULTS
  One hundred and seventeen public sector patients and 113 private sector patients were identified during the study period. Thirty-seven public patients (32%) and 46 private patients (41%) required re-operation. This difference was not significant (χ(2) = 2.06, degrees of freedom (df) = 1, P = 0.15). The mean time and standard error from the initial consultation to the first operation and re-operation in the public sector was 26 (2.3) and 62 (3.8) days, and in the private sector was 12 (1.2) and 30 (4.4) days, respectively P < 0.001. On average, 70% of public patients and 96% of private patients completed the surgical component of their breast cancer management within the Queensland Health-recommended time frame of 30 days (χ(2) = 26, df = 1, P < 0.001).
  
  
  CONCLUSIONS
  While experiencing similar rates of re-operative surgery in breast cancer management in the public and private sectors, the private sector deals with this issue in a more time efficient manner. An opportunity for intervention by quarantining theatre time is explored to improve the public sector time management.
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Solomon
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Colin T
authors.initials: CT
authors.lastname: Cochrane
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Queensland, Australia.|Department of Surgery, Nambour General Hospital, Nambour, Queensland, Australia.
authors.forename: David A
authors.initials: DA
authors.lastname: Grieve
mesh_terms: D001943:Breast Neoplasms / Q000191:economics* / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D016304:Hospitals, Private / Q000191:economics; D006779:Hospitals, Public / Q000191:economics; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D015412:Mastectomy, Segmental / Q000191:economics* / Q000379:methods*; D008875:Middle Aged; D017149:Private Sector; D011793:Queensland; D012086:Reoperation / Q000191:economics; D012189:Retrospective Studies; D013997:Time Factors
keywords: adjuvant chemotherapy; breast cancer; breast-conserving surgery; health insurance; loco-regional treatment