"You're the person for me:" patient perceptions of cancer care team selection and experiences with care coordination within a rural hub-and-spoke health system.

PURPOSE: Cancer care requires coordination across several clinical and supportive care specialties. Patients often need multidisciplinary teams to receive guideline-supported care; however, little is known about patients' perceptions of care team selection and coordination, particularly in the context of a rural hub-and-spoke health-care system.

METHODS

In this qualitative study, we conducted semi-structured interviews with patients regarding breast, lung, or colorectal cancer who received treatment at a large, rural academic health system. The cancer multi-team systems (cMTS) framework guided interview coding and analysis.

RESULTS

We conducted interviews with 11 breast, 11 lung, and 12 colorectal cancer patients. The mean participant age was 66 (range: 34-85); 56% were female, and 41% lived in a rural area. Half (n = 17) received care only at the central hub location, with most remaining participants (n = 13) receiving care across both hub-and-spoke facilities. Results include two main themes: 1) patient preferences, including past experience, interpersonal factors, and practical issues, drove patient care team and facility selection; and 2) patient experiences with providers influenced perceptions of team-based care and teaming processes. We did not discern differences between participants whose care teams were colocated at the hub hospital compared with those spanning hub-and-spoke. We used the cMTS framework to illustrate the inputs and processes most relevant to this study population's decisions and perceptions regarding care delivery.

CONCLUSION

Findings contribute to our understanding of patient preferences related to care team selection. These factors could be important in shaping future development of multidisciplinary cancer care teams.