title: Identifying clinical and support service resources and network practices for cancer patients and survivors in southern Puerto Rico.
abstract: OBJECTIVE
  The objectives of this study were to identify cancer-related health care services and to explore the presence of inter-organizational interactions among clinical and support oncology services in southern Puerto Rico.
  
  
  METHODS
  From January through July of 2010, a survey was completed by 54 health care organizations offering clinical, supportive, or both services to cancer patients/survivors (CPS) in southern PR. Survey data were compiled and descriptive analyses performed using the software Statistical Package for a Social Science (SPSS), version 18.0.
  
  
  RESULTS
  The distribution of the primary services provided by the participating organizations was the following: 26 had clinical services, 16 had support services, and 12 offered a combination of clinical and support services. Only 24 % of the surveyed organizations offered their services exclusively to patients diagnosed with cancer. In terms of referral practices, 61 % of the responses were for medical specialists, 43 % were for mental health services, and 37 % were referrals for primary care services. The most common reason for interacting (n = 27) was to provide a given patient both a referral and information.
  
  
  CONCLUSIONS
  Findings suggest gaps in both the availability of oncology services and the delivery of integrated health care. Lack of communication among clinical and support organizations (for cancer patients, specifically) could negatively impact the quality of the services that they offer. Further network analysis studies are needed to confirm these gaps. Until systemic, structural changes occur, more efforts are needed to facilitate communication and collaboration among these kinds of organization.
authors.affiliation: Department of Psychology, Ponce School of Medicine and Health Sciences, #388 Zona Industrial Reparada 11, Ponce, 00716, Puerto Rico, ecastro@psm.edu.
authors.forename: Eida M
authors.initials: EM
authors.lastname: Castro
authors.forename: Julio C
authors.initials: JC
authors.lastname: Jiménez
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Quinn
authors.forename: Myra
authors.initials: M
authors.lastname: García
authors.forename: Yesenia
authors.initials: Y
authors.lastname: Colón
authors.forename: Axel
authors.initials: A
authors.lastname: Ramos
authors.forename: Thomas
authors.initials: T
authors.lastname: Brandon
authors.forename: Vani
authors.initials: V
authors.lastname: Simmons
authors.forename: Clement
authors.initials: C
authors.lastname: Gwede
authors.forename: Susan
authors.initials: S
authors.lastname: Vadaparampil
authors.forename: Cruz María
authors.initials: CM
authors.lastname: Nazario
mesh_terms: D000328:Adult; D000368:Aged; D019058:Community Networks / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000458:organization & administration; D054625:Healthcare Disparities / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D011647:Puerto Rico / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012944:Social Support; D017741:Survivors / Q000706:statistics & numerical data*