Skelton Mac, Alameddine Raafat, Saifi Omran, Hammoud Miza, Zorkot Maya, Daher Marilyne, Charafeddine Maya, Temraz Sally, Shamseddine Ali, Mula-Hussain Layth, Saleem Mohammed, Namiq Kazim F, Dewachi Omar, Abu Sitta Ghassan, Abdul-Sater Zahi, Telvizian Talar, Faraj Walid, Mukherji Deborah
Institute of Regional and International Studies, American University of Iraq, Sulaimani, Iraq.
Department of Hematology/Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
JCO Glob Oncol. 2020 Feb;6:59-66. doi: 10.1200/JGO.19.00281.
Conflict-induced cross-border travel for medical treatment is commonly observed in the Middle East. There has been little research conducted on the financial impact this has on patients with cancer or on how cancer centers can adapt their services to meet the needs of this population. This study examines the experience of Iraqi patients seeking care in Lebanon, aiming to understand the social and financial contexts of conflict-related cross-border travel for cancer diagnosis and treatment.
After institutional review board approval, 60 Iraqi patients and caregivers seeking cancer care at a major tertiary referral center in Lebanon were interviewed.
Fifty-four respondents (90%) reported high levels of financial distress. Patients relied on the sale of possessions (48%), the sale of homes (30%), and vast networks to raise funds for treatment. Thematic analysis revealed several key drivers for undergoing cross-border treatment, including the conflict-driven exodus of Iraqi oncology specialists; the destruction of hospitals or road blockages; referrals by Iraqi physicians to Lebanese hospitals; the geographic proximity of Lebanon; and the lack of diagnostic equipment, radiotherapy machines, and reliable provision of chemotherapy in Iraqi hospitals.
As a phenomenon distinct from medical tourism, conflict-related deficiencies in health care at home force patients with limited financial resources to undergo cancer treatment in neighboring countries. We highlight the importance of shared decision making and consider the unique socioeconomic status of this population of patients when planning treatment.
在中东地区，因冲突导致的跨境就医现象很常见。关于这对癌症患者的经济影响，以及癌症中心如何调整服务以满足这部分人群的需求，目前几乎没有相关研究。本研究调查了在黎巴嫩寻求治疗的伊拉克患者的经历，旨在了解与冲突相关的跨境癌症诊断和治疗的社会及经济背景。
经机构审查委员会批准，对60名在黎巴嫩一家主要的三级转诊中心寻求癌症治疗的伊拉克患者及其护理人员进行了访谈。
54名受访者（90%）表示经济困难程度很高。患者依靠变卖财产（48%）、出售房屋（30%）以及庞大的人际关系网络来筹集治疗资金。主题分析揭示了接受跨境治疗的几个关键驱动因素，包括伊拉克肿瘤专家因冲突而外流；医院遭到破坏或道路受阻；伊拉克医生将患者转诊至黎巴嫩医院；黎巴嫩地理位置临近；以及伊拉克医院缺乏诊断设备、放疗机且化疗供应不可靠。
作为一种有别于医疗旅游的现象，国内医疗保健方面与冲突相关的缺陷迫使经济资源有限的患者前往邻国接受癌症治疗。我们强调共同决策的重要性，并在规划治疗时考虑这部分患者独特的社会经济状况。
