title: Perspectives of cancer survivors on the role of different healthcare providers in an integrated delivery system.
abstract: OBJECTIVE
  The purpose of this paper is to describe patient perspectives on survivorship care 1 year after cancer diagnosis.
  
  
  METHODS
  The study was conducted at an integrated healthcare delivery system in western Washington State. Participants were patients with breast, colorectal, and lung cancer who had enrolled in a randomized control trial (RCT) of oncology nurse navigation to improve early cancer care. Those alive and enrolled in the healthcare system 1 year after diagnosis were eligible for this analysis. Participants completed surveys by phone. Questions focused on receipt of treatment summaries and care plans; discussions with different providers; patient opinions on who does and should provide their care; and patient perspectives primary care providers' (PCP) knowledge and skills related to caring for cancer survivors
  
  
  RESULTS
  Of the 251 participants in the RCT, 230 (91.6%) responded to the 12-month phone survey and were included in this analysis; most (n = 183, 79.6%) had breast cancer. The majority (84.8%) considered their cancer specialist (e.g., medical, radiation, surgical or gynecological oncologist) to be their main provider for cancer follow-up and most (69.4%) had discussed follow-up care with that provider. Approximately half of patients were uncertain how well their PCP communicated with the oncologist and how knowledgeable s/he was in caring for cancer survivors.
  
  
  CONCLUSIONS
  One year after diagnosis, cancer survivors continue to view cancer specialists as their main providers and are uncertain about their PCP's skills and knowledge in managing their care. Our findings present an opportunity to help patients understand what their PCPs can and cannot provide in the way of cancer follow-up care.
  
  
  CONCLUSIONS
  Additional research on care coordination and delivery is necessary to help cancer survivors manage their care between primary care and specialty providers.
authors.affiliation: Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA, chubak.j@ghc.org.
authors.forename: Jessica
authors.initials: J
authors.lastname: Chubak
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Aiello Bowles
authors.forename: Leah
authors.initials: L
authors.lastname: Tuzzio
authors.forename: Evette
authors.initials: E
authors.lastname: Ludman
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Rutter
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Reid
authors.forename: Edward H
authors.initials: EH
authors.lastname: Wagner
mesh_terms: D000368:Aged; D019033:Delivery of Health Care, Integrated; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D024382:Professional Role; D017741:Survivors