title: Health care concerns of rural childhood cancer survivors.
abstract: BACKGROUND
  Geographic isolation may limit health care access due to burdens of time, cost and travel distance. We explored rural childhood cancer survivors' experiences and concerns about accessing affordable, quality care.
  
  
  METHODS
  In-depth, semi-structured telephone interviews were conducted with 17 rural adult survivors recruited from the Utah Cancer Registry. Interviews were recorded, transcribed, and content analyzed with NVivo 9 by two coders (kappa = 0.93).
  
  
  RESULTS
  Two primary themes emerged: (1) concerns about health care quality and (2) geographic and insurance issues. Within these main themes, we identified salient sub-themes: quality of primary care, patient-provider trust, specialty care access, travel burdens, and financial and insurance concerns.
  
  
  CONCLUSIONS
  Rural childhood cancer survivors have concerns about local health care services, but are willing to travel several hours to receive care. Partnerships between local primary care and cancer specialty providers via telemedicine that incorporate survivor care plans could improve risk-based care for rural survivors.
authors.forename: Echo L
authors.initials: EL
authors.lastname: Warner
authors.forename: Roberto E
authors.initials: RE
authors.lastname: Montenegro
authors.forename: Antoinette
authors.initials: A
authors.lastname: Stroup
authors.forename: Anita Y
authors.initials: AY
authors.lastname: Kinney
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D011787:Quality of Health Care; D012424:Rural Population; D017741:Survivors / Q000523:psychology*; D035502:Trust; D014589:Utah; D055815:Young Adult