DOI: https://doi.org/10.36347/sasjm.2025.v11i06.005

Pages: 616-625

Background: Delays in medical care represent a significant public health challenge with substantial impacts on morbidity, mortality, and healthcare costs. These delays can occur at various stages of the care pathway, from symptom recognition by patients to treatment initiation. This systematic review aims to synthesize current evidence on the determinants, consequences, and interventions to reduce these delays through rigorous analysis of published studies. Materials and methods: A comprehensive search was conducted in PubMed, Embase, and Cochrane Library databases for studies published between January 2000 and December 2023. Search strategies combined MeSH terms and keywords: "delays in care," "access to care," "diagnosis," "treatment," and "interventions." Included studies were observational or interventional studies evaluating delayed care in adult patients with quantitative data on delays or consequences. Case studies, literature reviews, and in vitro studies were excluded. Methodological quality was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. Data extracted included study characteristics, delay determinants, consequences, and interventions. Meta-analyses were performed where appropriate using random-effects models. Results: Multiple factors influence delays in care. For instance, patients in rural areas experienced average delays 2.5 days longer for cardiac symptom consultation compared to urban residents. Patients with lower education levels were 1.8 times more likely to delay consultation for suspected cancer. Regarding consequences, meta-analysis revealed that each day of delay in stroke treatment increased death or disability risk by 5%. Interventions showed promise: patient education programs reduced cardiac symptom consultation delays by 30%, while telemedicine systems decreased specialist referral time for suspected cancer by 20%. Conclusion: Delayed medical care repr