THE IMPACT OF GLOBAL CRISIS IN ONE PATIENT’S OUTCOME

Introduction and Objectives In recent years, the global financial crisis has reflected in population’s health, either by decreasing public investment in health or by creating economic difficulties in citizens. This case aims to demonstrate the impact of these difficulties in the citizens’ access to healthcare. Methods (case description) F.A. is a 58 year-old male, living in Figueira da Foz, suffering from chronic alcoholism, severe esophagitis and gastritis, followed in September 2014 by his family doctor for alcohol withdrawal. He repeated an endoscopy revealing high degree dysplasia of the esophagus’ Malpighian epithelium. In November, he was sent to a gastroenterology consultation in the Hospital of Coimbra. The patient missed all appointments until June 2015, then returning stating resumption of alcohol consumption. Refers that is still awaiting the gastroenterology consultation. In September, he states that he has been missing the appointments in Coimbra because of economic difficulties. It is therefore requested an urgent consultation in the Hospital of Figueira da Foz. Fifteen days later, this query is attended by the patient, in which he repeats the endoscopy, now revealing a carcinoma of the esophagus. Currently, the patient is attending the radiotherapy service, awaiting neoadjuvant treatment. Discussion and Conclusions The patient’s economic difficulties implied the delay in the diagnosis of the carcinoma, which may lead to an adverse outcome, given the severity of the condition. Thus, it is also up to the family doctors to know the socioeconomic context of their patients, as this will have many implications managing their diseases.