title: Bridging the gap between financial distress and available resources for patients with cancer: a qualitative study.
abstract: OBJECTIVE
  Cancer treatment-related out-of-pocket costs create substantial financial distress for many patients. However, little work has been done to describe available financial resources and barriers to connecting those resources to patients.
  
  
  METHODS
  This was a single-center, qualitative study that used semistructured interviews and focus groups with social workers and financial care counselors. Interview guides were used to elicit feedback from study participants pertaining to the types of financial problems that their patients were experiencing, the process for addressing these issues, patient assistance resources, and access barriers.
  
  
  RESULTS
  Four interviews and two focus group sessions (n = 15) were conducted in which four themes emerged among the social work and financial care counselor samples. Participants cited (1) frustration over the lack of financial resources and increasingly stringent eligibility criteria, (2) barriers to providing assistance such as process inefficiencies, (3) limited resources to identify at- risk patients and refer them for services, and (4) inadequate insurance coverage and availability. To bridge the gap between increasing patient need and limited resources, participants suggested development of interventions designed to aid in patient screening and resource identification.
  
  
  CONCLUSIONS
  Oncology social workers and financial care counselors reported inadequate financial resources and faced barriers to matching appropriate resources with patients in need. Limited social work resources hindered early screening for financial distress. Interventions that focus on screening for early identification of financial distress and identification of resources are needed.
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute; and Duke Cancer Institute, Durham, NC sophia.smith@duke.edu.
authors.forename: Sophia K
authors.initials: SK
authors.lastname: Smith
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute; and Duke Cancer Institute, Durham, NC.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Nicolla
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute; and Duke Cancer Institute, Durham, NC.
authors.forename: S Yousuf
authors.initials: SY
authors.lastname: Zafar
mesh_terms: D017281:Cost of Illness; D017144:Focus Groups; D005102:Health Expenditures; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage; D008495:Medical Oncology; D009369:Neoplasms / Q000191:economics* / Q000523:psychology*; D058991:Patient Protection and Affordable Care Act; D036301:Qualitative Research; D012947:Social Work; D013315:Stress, Psychological; D014481:United States