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Addressing financial hardship in cancer care: Multidisciplinary perspectives
Theresa A Hastert1, Nora Akcasu2, Carly Schulz3
1Department of Oncology, Wayne State University, Detroit, MI, USA; Population Studies Program, Karmanos Cancer Institute, Detroit, MI, USA.
Objectives:
This qualitative study explores the experiences and perspectives of multidisciplinary professionals on addressing the financial concerns of people with cancer in the United States.
Methods:
We conducted semi-structured interviews with 17 professionals (9 clinicians, 5 social workers/navigators, 3 attorneys) who routinely address patients' cancer-related financial concerns. Discussion guide topics were informed by a conceptual framework of financial toxicity and included patient cost-related concerns, resources used, and unmet needs related to addressing financial issues. Interview transcripts were analyzed using conventional qualitative content analysis.
Results:
Participants across disciplines identified insurance, out-of-pocket costs, work, and transportation as the most common financial concerns they addressed. The resources used and barriers experienced varied by professional role. Clinicians identified making treatment accommodations and referrals to other professionals (e.g., social workers) as the most common strategies to address cost concerns and identified lack of information, time, and resources as barriers. Social workers and navigators addressed concerns through navigation and financial assistance, but experienced barriers related to gaps in available resources. Attorneys addressed concerns through education and taking a holistic view of patients' financial situations and identified client lack of understanding of issues related to financial hardship and available resources as an important barrier. Across disciplines, participants endorsed the need for more and earlier cost communication to prevent and address financial hardship.
Conclusion:
Professionals involved in cancer care and related services reported distinct experiences and barriers when addressing patient financial hardship.
Practice Implications:
Recognizing the unique roles and challenges of different professional groups can inform the development of multidisciplinary approaches to improve financial outcomes of people with cancer.
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