Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia

This study aimed to understand the lived experiences of patients with cancer that facing inequities in oncological care in the city of Medellín. Patients and Methods: A qualitative study was conducted based on the theoretical and methodological elements of the grounded theory, specifically the descr...

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Autores:: Higuita Gutiérrez, Luis Felipe
Estrada Mesa, Diego Alejandro
Cardona Arias, Jaiberth Antonio

Tipo de recurso:: Article of investigation

Fecha de publicación:: 2022

Institución:: Universidad Cooperativa de Colombia

Repositorio:: Repositorio UCC

Idioma:

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repository_id_str
dc.title.spa.fl_str_mv	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
title	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
spellingShingle	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia Cancer Health inequities Grounded theory Cancer Health inequities Grounded theory
title_short	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
title_full	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
title_fullStr	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
title_full_unstemmed	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
title_sort	Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia
dc.creator.fl_str_mv	Higuita Gutiérrez, Luis Felipe Estrada Mesa, Diego Alejandro Cardona Arias, Jaiberth Antonio
dc.contributor.author.none.fl_str_mv	Higuita Gutiérrez, Luis Felipe Estrada Mesa, Diego Alejandro Cardona Arias, Jaiberth Antonio
dc.subject.spa.fl_str_mv	Cancer Health inequities Grounded theory
topic	Cancer Health inequities Grounded theory Cancer Health inequities Grounded theory
dc.subject.other.spa.fl_str_mv	Cancer Health inequities Grounded theory
description	This study aimed to understand the lived experiences of patients with cancer that facing inequities in oncological care in the city of Medellín. Patients and Methods: A qualitative study was conducted based on the theoretical and methodological elements of the grounded theory, specifically the description and conceptual ordering of Corbin and Strauss. Sixteen patients with cancer, who belonged to low (n=5), middle (n=4) and high (n=7) social classes, were included by theoretical sampling with category saturation. Data were collected using semi-structured interviews and analyzed in a category system based on the three social classes. The patients were aged between 23 and 71 years old, and they were diagnosed with different types of cancer such as breast, cervical, prostate, stomach, leukemia and lymphoma. Patients’ experiences showed that diagnosis, specialized care, treatment and hospital discharge were different based on their social class. Patients’ lived experiences associated with cancer reflect complex social situations, in which social determinants affect the level of citizens’ empowerment and self-management against the risks of get disease and die. Being part of low and middle social classes meant being subjected to a dehumanized, cold, impersonal and discontinuous treatment, in which healthcare was focused on the disease instead of individuals’ preferences and values. In contrast, patients belonging to the high class had the resources necessary to face risks, which ensured access to more humanized and individualized healthcare.
publishDate	2022
dc.date.accessioned.none.fl_str_mv	2022-09-14T15:15:22Z
dc.date.available.none.fl_str_mv	2022-09-14T15:15:22Z
dc.date.issued.none.fl_str_mv	2022-08-05
dc.type.none.fl_str_mv	Artículos Científicos
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dc.identifier.issn.spa.fl_str_mv	1177-889X
dc.identifier.uri.spa.fl_str_mv	https://doi.org/10.2147/PPA.S369628
dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/20.500.12494/46384
dc.identifier.bibliographicCitation.spa.fl_str_mv	Higuita Gutiérrez, L.F., Estrada Mesa, D.A., Cardona-Arias, J.A. (2022). Healthcare Inequities Experienced by Patients with Cancer: A Qualitative Study in Medellín, Colombia. Patient preferences and adherences, 5 ago 2022.https://repository.ucc.edu.co/handle/20.500.12494/46384
identifier_str_mv	1177-889X Higuita Gutiérrez, L.F., Estrada Mesa, D.A., Cardona-Arias, J.A. (2022). Healthcare Inequities Experienced by Patients with Cancer: A Qualitative Study in Medellín, Colombia. Patient preferences and adherences, 5 ago 2022.https://repository.ucc.edu.co/handle/20.500.12494/46384
url	https://doi.org/10.2147/PPA.S369628 https://hdl.handle.net/20.500.12494/46384
dc.relation.isversionof.spa.fl_str_mv	https://www.dovepress.com/healthcare-inequities-experienced-by-patients-with-cancer-a-qualitativ-peer-reviewed-fulltext-article-PPA
dc.relation.ispartofjournal.spa.fl_str_mv	Patient Prefer Adherence
dc.relation.references.spa.fl_str_mv	Braveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27(1):167–194. doi:10.1146/annurev.publhealth.27.021405.102103 World Health Organization. 10 facts on health inequities and their causes; 2011. Available from: https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes. Accessed August 3, 2022 National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Community-Based Solutions to Promote Health Equity in the United States. The root causes of health inequity. In: Baciu A, Negussie Y, Geller A, editors. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US); 2017. Steinberg ML. Inequity in cancer care: explanations and solutions for disparity. Semin Radiat Oncol. 2008;18(3):161–167. doi:10.1016/j.semradonc.2008.01.003 Evans N 3rd, Grenda T, Alvarez NH, Okusanya OT. Narrative review of socioeconomic and racial disparities in the treatment of early stage lung cancer. J Thorac Dis. 2021;13(6):3758–3763. doi:10.21037/jtd-20-3181 Sosa E, D’Souza G, Akhtar A, et al. Racial and socioeconomic disparities in lung cancer screening in the United States: a systematic review. CA Cancer J Clin. 2021;71(4):299–314. doi:10.3322/caac.21671 Chan J, Polo A, Zubizarreta E, et al. Access to radiotherapy and its association with cancer outcomes in a high-income country: addressing the inequity in Canada. Radiother Oncol. 2019;141:48–55. doi:10.1016/j.radonc.2019.09.009 Maddison AR, Asada Y, Urquhart R. Inequity in access to cancer care: a review of the Canadian literature. Cancer Causes Control. 2011;22(3):359–366. doi:10.1007/s10552-010-9722-3 Doll KM, Snyder CR, Ford CL. Endometrial cancer disparities: a race-conscious critique of the literature. Am J Obstet Gynecol. 2018;218(5):474–482.e2. doi:10.1016/j.ajog.2017.09.016 Sparla A, Flach-Vorgang S, Villalobos M, et al. Reflection of illness and strategies for handling advanced lung cancer - A qualitative analysis in patients and their relatives. BMC Health Serv Res. 2017;17(1):173. doi:10.1186/s12913-017-2110-x Arias-Ortiz NE, de Vries E. Health inequities and cancer survival in Manizales, Colombia: a population-based study. Colomb Med. 2018;49(1):63–72. doi:10.25100/cm.v49i1.3629 de Vries E, Uribe C, Pardo C, Lemmens V, van de Poel E, Forman D. Gastric cancer survival and affiliation to health insurance in a middle-income setting. Cancer Epidemiol. 2015;39(1):91–96. doi:10.1016/j.canep.2014.10.012 Arroyave I, Cardona D, Burdorf A, Avendano M. The impact of increasing health insurance coverage on disparities in mortality: health care reform in Colombia, 1998-2007. Am J Public Health. 2013;103(3):e100–6. doi:10.2105/AJPH.2012.301143 Strauss A, Corbin J. Basics of Qualitative Research Techniques and Procedures for Developing Grounded Theory [Bases de investigación cualitativa. Técnicas y procedimientos para desarrollar la teoría fundamentada]. 2da ed. Medellín: Universidad de Antioquia; 2012. Souza Minayo M. The structuring concepts of qualitative research [Los conceptos estructurantes de la investigación cualitativa]. Salud Colect. 2010;6(3):251–261. doi:10.18294/sc.2010.283 Gadamer H-G. Truth and Method. Continuum Publishing Group; 2004. Frechette J, Bitzas V, Aubry M, Kilpatrick K, Lavoie-Tremblay M. Capturing lived experience: methodological considerations for interpretive phenomenological inquiry. Int J Qual Methods. 2020;19:1–12. doi:10.1177/1609406920907254 Estrada Mesa DA, Cardona Arias JA. Medical humanities from the perspective of medical students[Las humanidades médicas desde la perspectiva de estudiantes de medicina]. Bogota: Ediciones Universidad Cooperativa de Colombia; 2020. doi:10.16925/9789587602647 Castillo E. Vásquez, Martha Lucía. methodological rigor in cualitative research [El rigor metodológico en la investigación cualitativa]. Colombia Médica. 2003;34(3):164–167. Cardona-Arias J, Salas-Zapata W, Carmona-Fonseca J. Challenges for the incorporation of metrics in social determinants of health approaches[Retos para la incorporación de métricas en los enfoques de la determinación social de la salud]. Med Soc. 2020;13:33. Curry LA, Nembhard IM, Bradley EH. Qualitative and mixed methods provide unique contributions to outcomes research. Circulation. 2009;119(10):1442–1452. doi:10.1161/CIRCULATIONAHA.107.742775 Bauer GR. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity. Soc Sci Med. 2014;110:10–17. doi:10.1016/j.socscimed.2014.03.022 Wolfson JA. Poverty and survival in childhood cancer: a framework to move toward systemic change. J Natl Cancer Inst. 2021;113(3):227–230. doi:10.1093/jnci/djaa108 Bermedo-Carrasco S, Waldner CL. The role of socio-demographic factors in premature cervical cancer mortality in Colombia. BMC Public Health. 2016;16(1):981. doi:10.1186/s12889-016-3645-1 Defensoría del pueblo de Colombia. Tutelage and rights to health and social insurance in colombia [La tutela y los derechos a la salud y a la seguridad social]; 2019. Available from: https://www.defensoria.gov.co/public/pdf/Estudio-La-Tutela-Derechos-Salud-Seguridad-Social-2019.pdf. Accessed August 3, 2022. Uribe Parra D, Pulido Martínez DC, De Vries E. Access to diagnostic facilities in children with cancer in Colombia: spotting opportunity and distance from a sample. Cancer Epidemiol. 2020;64:101645. doi:10.1016/j.canep.2019.101645 Somayaji D, Melendez M, Kwon M, Lathan C. Access to cancer care resources in a federally qualified health center: a mixed methods study to increase the understanding of met and unmet needs of cancer survivors. J Cancer Educ. 2021;36(3):591–602. doi:10.1007/s13187-019-01669-1 Zhou Y, Bemanian A, Beyer KM. Housing discrimination, residential racial segregation, and colorectal cancer survival in Southeastern Wisconsin. Cancer Epidemiol Biomarkers Prev. 2017;26(4):561–568. PMID: 28196847. doi:10.1158/1055-9965.EPI-16-0929 Ferrell BR, Kravitz K. Cancer care: supporting underserved and financially burdened family caregivers. J Adv Pract Oncol. 2017;8(5):494–500. Organización Mundial de la Salud. How WHO define health? [¿Cómo define la OMS la salud?]; 2021. Available from: https://www.who.int/es/about/frequently-asked-questions. Accessed August 3, 2022. Grisales-Naranjo LV, Arias-Valencia MM. Humanized care; the case of patients subjected to chemotherapy. Invest Educ Enferm. 2013;31(3):364–376. McIlfatrick S, Sullivan K, McKenna H, Parahoo K. Patients’ experiences of having chemotherapy in a day hospital setting. J Adv Nurs. 2007;59(3):264–273. doi:10.1111/j.1365-2648.2007.04324.x Canguilhem G. Writings on Medicine. New York: Fordham University Press; 2012 Rose N. The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century [Políticas de la vida: Biomedicina, poder y subjetividad en el siglo XXI]. La Plata: UNIPE Editorial Universitaria; 2012.
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spelling	Higuita Gutiérrez, Luis FelipeEstrada Mesa, Diego AlejandroCardona Arias, Jaiberth Antonio2022:162022-09-14T15:15:22Z2022-09-14T15:15:22Z2022-08-051177-889Xhttps://doi.org/10.2147/PPA.S369628https://hdl.handle.net/20.500.12494/46384Higuita Gutiérrez, L.F., Estrada Mesa, D.A., Cardona-Arias, J.A. (2022). Healthcare Inequities Experienced by Patients with Cancer: A Qualitative Study in Medellín, Colombia. Patient preferences and adherences, 5 ago 2022.https://repository.ucc.edu.co/handle/20.500.12494/46384This study aimed to understand the lived experiences of patients with cancer that facing inequities in oncological care in the city of Medellín. Patients and Methods: A qualitative study was conducted based on the theoretical and methodological elements of the grounded theory, specifically the description and conceptual ordering of Corbin and Strauss. Sixteen patients with cancer, who belonged to low (n=5), middle (n=4) and high (n=7) social classes, were included by theoretical sampling with category saturation. Data were collected using semi-structured interviews and analyzed in a category system based on the three social classes. The patients were aged between 23 and 71 years old, and they were diagnosed with different types of cancer such as breast, cervical, prostate, stomach, leukemia and lymphoma. Patients’ experiences showed that diagnosis, specialized care, treatment and hospital discharge were different based on their social class. Patients’ lived experiences associated with cancer reflect complex social situations, in which social determinants affect the level of citizens’ empowerment and self-management against the risks of get disease and die. Being part of low and middle social classes meant being subjected to a dehumanized, cold, impersonal and discontinuous treatment, in which healthcare was focused on the disease instead of individuals’ preferences and values. In contrast, patients belonging to the high class had the resources necessary to face risks, which ensured access to more humanized and individualized healthcare.El CvLac lleva varios meses que no funcionahttps://orcid.org/0000-0003-1361-3124El GrupLac lleva varios meses que no funcionaluis.higuita@campusucc.edu.cohttps://scholar.google.com/citations?user=zr_ri68AAAAJ&hl=en1983—1997Universidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Medicina, Medellín y EnvigadoDove PressMedicinaMedellínhttps://www.dovepress.com/healthcare-inequities-experienced-by-patients-with-cancer-a-qualitativ-peer-reviewed-fulltext-article-PPAPatient Prefer AdherenceBraveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27(1):167–194. doi:10.1146/annurev.publhealth.27.021405.102103World Health Organization. 10 facts on health inequities and their causes; 2011. Available from: https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes. Accessed August 3, 2022National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Community-Based Solutions to Promote Health Equity in the United States. The root causes of health inequity. In: Baciu A, Negussie Y, Geller A, editors. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US); 2017.Steinberg ML. Inequity in cancer care: explanations and solutions for disparity. Semin Radiat Oncol. 2008;18(3):161–167. doi:10.1016/j.semradonc.2008.01.003Evans N 3rd, Grenda T, Alvarez NH, Okusanya OT. Narrative review of socioeconomic and racial disparities in the treatment of early stage lung cancer. J Thorac Dis. 2021;13(6):3758–3763. doi:10.21037/jtd-20-3181Sosa E, D’Souza G, Akhtar A, et al. Racial and socioeconomic disparities in lung cancer screening in the United States: a systematic review. CA Cancer J Clin. 2021;71(4):299–314. doi:10.3322/caac.21671Chan J, Polo A, Zubizarreta E, et al. Access to radiotherapy and its association with cancer outcomes in a high-income country: addressing the inequity in Canada. Radiother Oncol. 2019;141:48–55. doi:10.1016/j.radonc.2019.09.009Maddison AR, Asada Y, Urquhart R. Inequity in access to cancer care: a review of the Canadian literature. Cancer Causes Control. 2011;22(3):359–366. doi:10.1007/s10552-010-9722-3Doll KM, Snyder CR, Ford CL. Endometrial cancer disparities: a race-conscious critique of the literature. Am J Obstet Gynecol. 2018;218(5):474–482.e2. doi:10.1016/j.ajog.2017.09.016Sparla A, Flach-Vorgang S, Villalobos M, et al. Reflection of illness and strategies for handling advanced lung cancer - A qualitative analysis in patients and their relatives. BMC Health Serv Res. 2017;17(1):173. doi:10.1186/s12913-017-2110-xArias-Ortiz NE, de Vries E. Health inequities and cancer survival in Manizales, Colombia: a population-based study. Colomb Med. 2018;49(1):63–72. doi:10.25100/cm.v49i1.3629de Vries E, Uribe C, Pardo C, Lemmens V, van de Poel E, Forman D. Gastric cancer survival and affiliation to health insurance in a middle-income setting. Cancer Epidemiol. 2015;39(1):91–96. doi:10.1016/j.canep.2014.10.012Arroyave I, Cardona D, Burdorf A, Avendano M. The impact of increasing health insurance coverage on disparities in mortality: health care reform in Colombia, 1998-2007. Am J Public Health. 2013;103(3):e100–6. doi:10.2105/AJPH.2012.301143Strauss A, Corbin J. Basics of Qualitative Research Techniques and Procedures for Developing Grounded Theory [Bases de investigación cualitativa. Técnicas y procedimientos para desarrollar la teoría fundamentada]. 2da ed. Medellín: Universidad de Antioquia; 2012.Souza Minayo M. The structuring concepts of qualitative research [Los conceptos estructurantes de la investigación cualitativa]. Salud Colect. 2010;6(3):251–261. doi:10.18294/sc.2010.283Gadamer H-G. Truth and Method. Continuum Publishing Group; 2004.Frechette J, Bitzas V, Aubry M, Kilpatrick K, Lavoie-Tremblay M. Capturing lived experience: methodological considerations for interpretive phenomenological inquiry. Int J Qual Methods. 2020;19:1–12. doi:10.1177/1609406920907254Estrada Mesa DA, Cardona Arias JA. Medical humanities from the perspective of medical students[Las humanidades médicas desde la perspectiva de estudiantes de medicina]. Bogota: Ediciones Universidad Cooperativa de Colombia; 2020. doi:10.16925/9789587602647Castillo E. Vásquez, Martha Lucía. methodological rigor in cualitative research [El rigor metodológico en la investigación cualitativa]. Colombia Médica. 2003;34(3):164–167.Cardona-Arias J, Salas-Zapata W, Carmona-Fonseca J. Challenges for the incorporation of metrics in social determinants of health approaches[Retos para la incorporación de métricas en los enfoques de la determinación social de la salud]. Med Soc. 2020;13:33.Curry LA, Nembhard IM, Bradley EH. Qualitative and mixed methods provide unique contributions to outcomes research. Circulation. 2009;119(10):1442–1452. doi:10.1161/CIRCULATIONAHA.107.742775Bauer GR. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity. Soc Sci Med. 2014;110:10–17. doi:10.1016/j.socscimed.2014.03.022Wolfson JA. Poverty and survival in childhood cancer: a framework to move toward systemic change. J Natl Cancer Inst. 2021;113(3):227–230. doi:10.1093/jnci/djaa108Bermedo-Carrasco S, Waldner CL. The role of socio-demographic factors in premature cervical cancer mortality in Colombia. BMC Public Health. 2016;16(1):981. doi:10.1186/s12889-016-3645-1Defensoría del pueblo de Colombia. Tutelage and rights to health and social insurance in colombia [La tutela y los derechos a la salud y a la seguridad social]; 2019. Available from: https://www.defensoria.gov.co/public/pdf/Estudio-La-Tutela-Derechos-Salud-Seguridad-Social-2019.pdf. Accessed August 3, 2022.Uribe Parra D, Pulido Martínez DC, De Vries E. Access to diagnostic facilities in children with cancer in Colombia: spotting opportunity and distance from a sample. Cancer Epidemiol. 2020;64:101645. doi:10.1016/j.canep.2019.101645Somayaji D, Melendez M, Kwon M, Lathan C. Access to cancer care resources in a federally qualified health center: a mixed methods study to increase the understanding of met and unmet needs of cancer survivors. J Cancer Educ. 2021;36(3):591–602. doi:10.1007/s13187-019-01669-1Zhou Y, Bemanian A, Beyer KM. Housing discrimination, residential racial segregation, and colorectal cancer survival in Southeastern Wisconsin. Cancer Epidemiol Biomarkers Prev. 2017;26(4):561–568. PMID: 28196847. doi:10.1158/1055-9965.EPI-16-0929Ferrell BR, Kravitz K. Cancer care: supporting underserved and financially burdened family caregivers. J Adv Pract Oncol. 2017;8(5):494–500.Organización Mundial de la Salud. How WHO define health? [¿Cómo define la OMS la salud?]; 2021. Available from: https://www.who.int/es/about/frequently-asked-questions. Accessed August 3, 2022.Grisales-Naranjo LV, Arias-Valencia MM. Humanized care; the case of patients subjected to chemotherapy. Invest Educ Enferm. 2013;31(3):364–376.McIlfatrick S, Sullivan K, McKenna H, Parahoo K. Patients’ experiences of having chemotherapy in a day hospital setting. J Adv Nurs. 2007;59(3):264–273. doi:10.1111/j.1365-2648.2007.04324.xCanguilhem G. Writings on Medicine. New York: Fordham University Press; 2012Rose N. The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century [Políticas de la vida: Biomedicina, poder y subjetividad en el siglo XXI]. La Plata: UNIPE Editorial Universitaria; 2012.CancerHealth inequitiesGrounded theoryCancerHealth inequitiesGrounded theoryHealthcare inequities experienced by patients with cancer: A qualitative study in Medellín, ColombiaArtículos Científicoshttp://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAtribucióninfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2PublicationORIGINALHiguitaGutierrez_HealthInequalities_Cancer_2022.pdfHiguitaGutierrez_HealthInequalities_Cancer_2022.pdfArtículoapplication/pdf1419616https://repository.ucc.edu.co/bitstreams/14b8ee53-57d6-4e02-8a19-a8ddf5c9f1cd/downloaddbe7c1fdbab00cd6666befcb753eed62MD51Licencia de uso RI Ver5 - 9-07-2021.pdfLicencia de uso RI Ver5 - 9-07-2021.pdfLicencia de usoapplication/pdf195886https://repository.ucc.edu.co/bitstreams/b5ac58bf-9918-4dd1-aef2-fb99fe73211b/downloadce27f5900ca9af41a626de9e5585a4acMD53LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repository.ucc.edu.co/bitstreams/ff904b67-eb6a-402e-a281-5912fb885a0d/download8a4605be74aa9ea9d79846c1fba20a33MD54THUMBNAILHiguitaGutierrez_HealthInequalities_Cancer_2022.pdf.jpgHiguitaGutierrez_HealthInequalities_Cancer_2022.pdf.jpgGenerated Thumbnailimage/jpeg6121https://repository.ucc.edu.co/bitstreams/7121d5bd-0299-47bf-8bbb-9c5b89308264/downloade0f88914c14de30aed4cf8b8f70e6cc0MD55Licencia de uso RI Ver5 - 9-07-2021.pdf.jpgLicencia de uso RI Ver5 - 9-07-2021.pdf.jpgGenerated Thumbnailimage/jpeg5223https://repository.ucc.edu.co/bitstreams/c673c507-d89c-418a-9380-e330eea525b3/downloadc984203d6f0930f0c98c1cc7c73d212eMD56TEXTHiguitaGutierrez_HealthInequalities_Cancer_2022.pdf.txtHiguitaGutierrez_HealthInequalities_Cancer_2022.pdf.txtExtracted texttext/plain82321https://repository.ucc.edu.co/bitstreams/a9a3066d-9fff-4932-8072-4e08084cd7d7/download7b5a58612e7691a7df7741beb3939ee8MD57Licencia de uso RI Ver5 - 9-07-2021.pdf.txtLicencia de uso RI Ver5 - 9-07-2021.pdf.txtExtracted texttext/plain5819https://repository.ucc.edu.co/bitstreams/487199d9-d0b9-444d-af15-8f708a05e00e/download243485cfee1c0558824c432adf7c9300MD5820.500.12494/46384oai:repository.ucc.edu.co:20.500.12494/463842024-08-10 22:48:08.545open.accesshttps://repository.ucc.edu.coRepositorio Institucional Universidad Cooperativa de Colombiabdigital@metabiblioteca.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

Healthcare inequities experienced by patients with cancer: A qualitative study in Medellín, Colombia

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