Table 6 Summary of key themes and implications for health services and research
Summarized themes | Relation to study objective | Health service or research implications |
|---|---|---|
Demographic characteristics create or exacerbate barriers | Frequent barrier | Improve breadth of patient participation and health literacy to reduce disparities |
Assess the degree to which services are culturally competent | ||
Target disadvantaged groups with additional supportive services | ||
Availability barriers exist at first point of contact | Common barrier | Provide explanations for and estimates of delays |
Service structures create accommodation and accessibility barriers | Common barrier | Improve appointment scheduling systems: |
- record individual preferences for date and time | ||
- coordinate all required appointments at the facility on one day | ||
-convenient rescheduling process | ||
Decrease wait-times | ||
Incorporate notification system for estimated wait-times | ||
Continuity and coordination of care poses barriers | Common barrier | Improve content and access to medical records: |
-systematic data collection for accuracy and completeness | ||
ability to record additional patient concerns | ||
-notification or alerts when test results are available | ||
-centralized progress summaries for multiple service providers | ||
Decisional involvement and information provision impacts acceptability of care | Common barrier | Provide personalized information to patients |
Provide ongoing opportunities to review progress and concerns | ||
Provide access to additional information sources | ||
Provide communication training for providers | ||
Consider and discuss individual patient preferences for decisional involvement | ||
Need assessment and referral processes for cancer and/or depression can be improved | Unique barrier | Conduct systematic, comprehensive and routine screening of patients’ needs |
Refer automatically to support services | ||
Inform health professionals of additional services available | ||
Barriers can be described in additional detail | Scope of barrier | Deconstruct barriers to design more targeted initiatives for improving access |
Evidence on barriers to non-oncology services is limited | Volume of articles | Barriers reported within clusters of conditions mask differences across groups |
Conduct more studies in non-oncology patient groups |