Financial Assistance Processes and Mechanisms in Rural and Nonrural Oncology Care Settings

被引:14
|
作者
Biddell, Caitlin B. [1 ,2 ]
Spees, Lisa P. [1 ,2 ]
Petermann, Victoria [2 ,3 ]
Rosenstein, Donald L. [2 ]
Manning, Michelle [2 ]
Gellin, Mindy [2 ]
Padilla, Neda [2 ]
Samuel-Ryals, Cleo A. [1 ,2 ]
Birken, Sarah A. [4 ,5 ]
Reeder-Hayes, Katherine [2 ,6 ]
Deal, Allison M. [2 ]
Cabarrus, Kendrel [1 ]
Bell, Ronny A. [4 ,5 ]
Strom, Carla [4 ,5 ]
DeAntonio, Phyllis A. [7 ]
Young, Tiffany H. [8 ]
King, Sherry [9 ]
Leutner, Brian [10 ]
Vestal, Derek [11 ]
Wheeler, Stephanie B. [1 ,2 ]
机构
[1] Univ N Carolina, Dept Hlth Policy & Management, Gillings Sch Global Publ Hlth, Chapel Hill, NC 27515 USA
[2] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27515 USA
[3] Univ N Carolina, Sch Nursing, Chapel Hill, NC 27515 USA
[4] Wake Forest Sch Med, Winston Salem, NC 27101 USA
[5] Wake Forest Baptist Comprehens Canc Ctr, Winston Salem, NC USA
[6] Univ N Carolina, Div Oncol, Chapel Hill, NC 27515 USA
[7] Vidant Hlth, Vidant Med Ctr, Greenville, NC USA
[8] Buddy Kemp Support Ctr, Novant Hlth Canc Inst, Charlotte, NC USA
[9] Carteret Hlth Care Canc Ctr, Morehead City, NC USA
[10] Pardee UNC Hlth Care, Hendersonville, NC USA
[11] UNC Lenoir Hlth Care, Kinston, NC USA
基金
美国国家卫生研究院;
关键词
CANCER SURVIVORS; PILOT FEASIBILITY; TOXICITY; DISTRESS; HARDSHIP; NAVIGATORS; MANAGEMENT; SCIENCE;
D O I
10.1200/OP.21.00894
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE: Patients with cancer are at heightened risk of experiencing financial hardship. Financial navigation (FN) is an evidence-based approach for identifying and addressing patient and caregiver financial needs. In preparation for the implementation of a multisite FN intervention, we describe existing processes (ie, events and actions) and mechanisms (ie, how events work together) connecting patients to financial assistance, comparing rural and nonrural practices. METHODS: We conducted in-depth, semistructured interviews with stakeholders (ie, administrators, providers, and staff) at each of the 10 oncology care sites across a single state (five rural and five nonrural practices). We developed process maps for each site and analyzed stakeholder perspectives using thematic analysis. After reporting findings back to stakeholders, we synthesized themes and process maps across rural and nonrural sites separately. RESULTS: Eighty-three stakeholders were interviewed. We identified six core elements of existing financial assistance processes across all sites: distress screening (including financial concerns), referrals, resource connection points, and pharmaceutical, insurance, and community/foundation resources. Processes differed by rurality; however, facilitators and barriers to identifying and addressing patient financial needs were consistent. Open communication between staff, providers, patients, and caregivers was a primary facilitator. Barriers included insufficient staff resources, challenges in routinely identifying needs, inadequate preparation of patients for anticipated medical costs, and limited tracking of resource availability and eligibility. CONCLUSION: This study identified a clear need for systematic implementation of oncology FN to equitably address patient and caregiver financial hardship. Results have informed our current efforts to implement a multisite FN intervention, which involves comprehensive financial toxicity screening and systematization of intake and referrals.
引用
收藏
页码:663 / E1406
页数:16
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