Outcomes

The primary outcome was the overall survival of patients registered in the FOSP database with the diagnosis of pancreatic exocrine (including non-classified) tumors from 2000 to 2014. Overall survival (OS) was defined as the time from the diagnosis to death (from any cause) or last follow-up visit. We also looked for factors associated with survival using Cox proportional hazard models, with emphasis on the source of health care provision (insurance coverage, public health system, or direct private payment).

Secondary outcomes were the patterns of health-care access evaluated by the rates of pathological confirmation of cancer, staging at time of diagnosis, the times from the first visit to specific clinical landmarks (diagnosis and treatment), and the frequency of any (and specific) anti-cancer treatment. Patterns of health care access were also analyzed according to the source of payment in search for differences in health care patterns throughout different economical scenarios. We conducted an exploratory analysis to evaluate the impact of the interactions between time period and source of payment in overall survival.