We Don't Care What You Know Until You Show Us That You Care': Characterizing Access to Healthcare among Black, Hispanic and White Cancer Survivors

Background: Healthcare access (HCA) encompasses five important dimensions: Affordability, Availability, Accessibility, Accommodation and Acceptability. Published studies of cancer typically focus on affordability, availability and accessibility, however accessibility and accommodation are typically less studied

Objectives: The goal of the current study is to conduct a qualitative study characterizing cancer survivor’s perceptions of HCA dimensions and to identify key facilitators or barriers to equitable healthcare among Black, Hispanic and White cancer survivors

Methods: We recruited a total of 32 cancer survivors into a qualitative study to understand their cancer treatment journey and experiences accessing healthcare. Over 60% of participants were Black, and 18% were Hispanic. Focus groups were moderated by an experienced facilitator, and data were coded and analyzed using NVivo 12 to identify key themes. Peer debriefing was done to evaluate the credibility and completeness of analysis

Results: Across the five HCA dimensions evaluated, acceptability emerged as the most important among cancer survivors. Acceptability was discussed in a variety of positive ways, such as the importance of bedside manner, patient-provider communication, and empathy. Accommodation—relating to ability to see provider when convenient, limited language barriers—were also identified as important. Faith and access to support groups were noted as facilitators of healthcare access, while role conflict was noted as a barrier

Conclusion: Access to healthcare is a top priority for cancer survivors, and impacts quality of initial treatment, supportive care and survival. Even when there were underlying concerns about affordability and accessibility, issues related to acceptability were key to survivor’s feeling a sense of psychological safety with their providers might be a specific, quantifiable and impactful measure of patient-centered, high-quality care

Learning Objectives:

1. Understand the 5 dimensions of healthcare access

2. Identify the salient healthcare access dimension for cancer survivors