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Patient and Caregiver Considerations and Priorities When Selecting Hospitals for Complex Cancer Care

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Healthcare policies have focused on centralizing care to high-volume centers in an effort to optimize patient outcomes; however, little is known about patients’ and caregivers’ considerations and selection process when selecting hospitals for care. We aim to explore how patients and caregivers select hospitals for complex cancer care and to develop a taxonomy for their selection considerations.

Methods

This was a qualitative study in which data were gathered from in-depth interviews conducted from March to November 2019 among patients with hepatopancreatobiliary cancers who were scheduled to undergo a pancreatectomy (n = 20) at a metropolitan, urban regional, or suburban medical center and their caregivers (n = 10).

Results

The interviews revealed six broad domains that characterized hospital selection considerations: hospital factors, team characteristics, travel distance to hospital, referral or recommendation, continuity of care, and insurance considerations. The identified domains were similar between participants seen at the metropolitan center and urban/suburban medical centers, with the following exceptions: participants receiving care specifically at the metropolitan center noted operative volume and access to specific services such as clinical trials in their hospital selection; participants receiving care at urban/suburban centers noted health insurance considerations and having access to existing medical records in their hospital selection.

Conclusions

This study delineates the many considerations of patients and caregivers when selecting hospitals for complex cancer care. These identified domains should be incorporated into the development and implementation of centralization policies to help increase patient access to high-quality cancer care that is consistent with their priorities and needs.

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Acknowledgments

Funding was provided by National Cancer Institute of the National Institute of Health (Grant No. F32CA217455).

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Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    Zhi Ven Fong MD, MPH, Carlos Fernandez-del Castillo MD, Ryan D. Nipp MD, MPH, Motaz Qadan MD, PhD, Cristina R. Ferrone MD, Andrew L. Warshaw MD, Keith D. Lillemoe MD & David C. Chang PhD, MPH, MBA

  2. Department of Surgery, Boston Medical Center, Boston, MA, USA

    Pei-Wen Lim MD

  3. Department of Surgery, University of Massachusetts, Worcester, MA, USA

    Ryan Hendrix MD, James M. Lindberg MD & Giles F. Whalen MD

  4. Department of Surgery, North Shore Medical Center, Salem, MA, USA

    William Kastrinakis MD

  5. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Lara N. Traeger PhD

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  1. Zhi Ven Fong MD, MPH
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  3. Ryan Hendrix MD
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Correspondence to Zhi Ven Fong MD, MPH.

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Fong, Z.V., Lim, PW., Hendrix, R. et al. Patient and Caregiver Considerations and Priorities When Selecting Hospitals for Complex Cancer Care. Ann Surg Oncol 28, 4183–4192 (2021). https://doi.org/10.1245/s10434-020-09506-2

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  • DOI: https://doi.org/10.1245/s10434-020-09506-2

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