Barriers to Optimal Lung Cancer Care in the Community Setting


A recent study identified four recurring themes related to organizational barriers to quality lung cancer care in a community hospital setting.

The study was published in The Journal of Community and Supportive Oncology (April 2018;16[2]:e89-e96).

Lung cancer poses a significant public health challenge in the United States due to its complicated process of care delivery. Many patients with lung cancer and their caregivers are faced with the challenge of navigating the barriers in health care systems while simultaneously coping with this disease.

Satish Kedia, PhD, school of public health, University of Memphis, and colleagues designed a study to define the potential barriers to receiving high quality health care from the perspective of patients with lung cancer and their caregivers. The qualitative study included 10 focus groups of patients (n = 22) and their caregivers (n = 24) from the Baptist Memorial Health Care system—which has some of the highest lung cancer incidence rates in the United States—and a rural setting in Grenada, Mississippi. Researchers investigated recurring themes related to organizational barriers to quality care by recording and transcribing guided discussions for analysis.

Based on participant feedback, researchers identified four main levels within the community hospital system where barriers to optimal care occurred: policy, institutional, provider, and patient. After conducting qualitative analyses, a central theme was found to be associated with each level, around which the barriers coalesced: lack of insurance, appointment scheduling, provider communication, and patient knowledge.

Dr Kedia and colleagues noted that participants viewed support with navigating the health care system—either from within the health care systems or through their own social network—as beneficial in coping with lung cancer, seeking information, expediting appointments, connecting patients to physicians, and receiving timely care.


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“Targeting barriers related to insurance coverage, appointment scheduling, provider-patient communication, and patient or family education about lung cancer and its treatment process will likely improve patient and caregiver experience of care,” Dr Kedia and colleagues concluded.

Authors of the study also acknowledged institutional and geographic differences in lung cancer care experience as a potential limitation to the generalizability of their results.—Zachary Bessette