title: Redesigning Cancer Care Delivery: Views From Patients and Caregivers.
abstract: Cancer is a leading cause of death in the United States. Although treatments have improved, patients and caregivers continue to report significant gaps in their care. The objective of this study was to examine the views of patients and caregivers on their experiences with current cancer care delivery and identify key strategies to improve the delivery of care.
  
  
  
  Semistructured interviews were conducted with 75 patients and 45 caregivers across the United States. The interviews were recorded, transcribed, and analyzed using constant comparative method of qualitative analysis.
  
  
  
  Participants reported multiple gaps in care delivery, including barriers in health communication with health care providers, lack of elucidation of care goals, lack of care coordination, and challenges in accessing care. Participants identified that greater use of nonphysician providers and alternative formats, such as telephone-based care and home and community-based care, would narrow these gaps.
  
  
  
  Understanding patients' and caregivers' experiences with gaps in cancer care delivery can inform cancer care delivery redesign efforts and lead to targeted interventions that result in patient-centered and family-oriented care.
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Manali I
authors.initials: MI
authors.lastname: Patel
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Vyjeyanthi S
authors.initials: VS
authors.lastname: Periyakoil
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Blayney
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: David
authors.initials: D
authors.lastname: Moore
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nevedal
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Steven
authors.initials: S
authors.lastname: Asch
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Arnold
authors.initials: A
authors.lastname: Milstein
authors.affiliation: Stanford University School of Medicine, Stanford; VA Palo Alto Health Care System, Palo Alto, CA; and University of Washington School of Medicine, Seattle, WA.
authors.forename: Tumaini R
authors.initials: TR
authors.lastname: Coker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003142:Communication; D003695:Delivery of Health Care / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D018802:Patient-Centered Care; D010361:Patients; D036301:Qualitative Research; D014481:United States / Q000453:epidemiology; D055815:Young Adult