School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, Maharashtra, India.
Centre for Health and Social Sciences, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
Int J Health Plann Manage. 2023 Sep;38(5):1396-1408. doi: 10.1002/hpm.3667. Epub 2023 Jun 4.
The cancer burden in northeast India is high, with low survival and low case detection. Despite the availability of cancer institutes in the region, existing literature remarks on the increasing travel outside the region for cancer care. However, research is sparse on identifying impediment factors to the access of state cancer institutes.
To examine the barriers to cancer care in five common cancer sites: oral, lungs, stomach, breast and cervix.
Following a descriptive multiple-embedded case study design integrating quantitative and qualitative approaches, 388 participants were selected in phase one by stratified random sampling. In phase two, by purposive sampling, 21 semi-structured interviews were conducted.
The result suggests that family decision is the central factor in cancer care access. Treatment initiation is delayed because the existing government health insurance scheme does not cover diagnostic tests. Adverse steps are taken to fund cancer treatment. Besides, opting for alternative medicines were due to fear of surgery, chemotherapy and recommendations by relatives. Arranging accommodation, transportation and infrastructure shortage was another hurdle. In contrast, the lack of awareness of the state cancer institutes was a barrier to its access.
This paper identifies and describes factors that hinder access to state cancer institutes. The findings could enhance policy interventions for efficient cancer care access in the region. Integration with NGOs working at the state level for cancer services would support ease of access by providing funds for diagnostic tests, accommodation and transportation, especially for those who cannot afford it.
印度东北部的癌症负担很重，生存率低，病例检出率低。尽管该地区有癌症研究所，但现有文献提到，越来越多的人前往该地区以外寻求癌症治疗。然而，关于阻碍人们进入州立癌症研究所的因素的研究还很少。
检查五个常见癌症部位（口腔、肺部、胃部、乳房和宫颈）的癌症护理障碍。
采用描述性多嵌入式案例研究设计，结合定量和定性方法，在第一阶段通过分层随机抽样选择了 388 名参与者。在第二阶段，通过目的抽样，进行了 21 次半结构化访谈。
结果表明，家庭决策是癌症护理获得的核心因素。由于现有政府医疗保险计划不涵盖诊断性检查，因此治疗启动被延迟。为了资助癌症治疗，采取了不利的措施。此外，由于害怕手术、化疗以及亲属的建议，人们选择了替代药物。安排住宿、交通和基础设施短缺也是一个障碍。相比之下，对州立癌症研究所的缺乏了解是阻碍其获得的一个因素。
本文确定并描述了阻碍进入州立癌症研究所的因素。这些发现可以为该地区提高癌症护理获得效率的政策干预提供参考。与在州一级开展癌症服务的非政府组织整合，将通过为诊断性检查、住宿和交通提供资金来支持那些无法负担这些费用的人的便利获得，特别是那些无法负担这些费用的人。
