[Time to diagnosis as an index of efficiency of the health care system--lymphoma study].

In the year 1999 the reform of the health care system was introduced in Poland. It was probably the biggest among many changes that the polish health care system underwent in the years 1990-2002. Still there are only a few unbiased analyses trying to assess possible influence of those changes on the function of the system. One of the ways may be the analysis of time to diagnosis. The aim of our work was to analyze time to diagnosis in lymphoma, and see the possible influence of changes in the system on it. The average time from the onset of the first symptoms to the contact with a general practitioner was 70 days (range 3 to 240 days) for all of the analyzed groups of patients. The reduction of time to diagnosis was observed during the years 1990-2002. The biggest change was present in the group of patients that presented with unspecific symptoms e.g. weight loss, fever (reduction of mean time to diagnosis from 47 days to 32 days, p < 0.05). The changes were due to the constant slow changes that are introduced in the function of health care system (improvement of qualifications of the doctors, better diagnostics techniques), and could not be contributed to the reform. In the group of patients with an enlargement of lymph nodes on presentation, we were not able to observe any changes in time to diagnosis.