Qualitative assessment of organizational barriers to optimal lung cancer care in a community hospital setting in the United States


Background Lung cancer is a major public health challenge in the United States with a complicated process of care delivery. In addition, it is a challenge for many lung cancer patients and their caregivers to navigate health care systems while coping with the disease. Objective To explore the organizational barriers to receiving quality health care from the perspective of lung cancer patients and their caregivers. Methods In a qualitative study involving 10 focus groups of patients and their caregivers, we recorded and transcribed guided discussions for analysis by using Dedoose software to investigate recurrent themes. Results Analysis of the transcriptions revealed 4 recurring themes related to organizational barriers to quality care: Insurance, scheduling, communication, and knowledge. The participants perceived support with navigating the health care system, either through their own social network or from within the health care systems, as beneficial in coping with the lung cancer, seeking information, expediting appointments, connecting patients to physicians, and receiving timely care. Limitations Institutional and geographic differences in the experience of lung cancer care may limit the generalizability of the results of this study. Conclusions This study offers insights into the perspectives of lung cancer patients and caregivers on the organizational barriers to receiving quality care. 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.

Publication Title

Journal of Community and Supportive Oncology