"Paying to Be a Patient in the Hospital and the Parking Lot": Patient-Caregiver Dyad Perspectives on Health-Related Transportation Access in Multiple Myeloma.
Shakira J Grant, Gabriell Erisnor, Jiona A Mills, Esther Wang, Lauren C Bates-Fraser, Leah Adams, Paul Mihas
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Abstract
Purpose: Transportation affects access to quality medical care and health equity, especially for vulnerable populations. Little is known about patients'(PTs) experiences, particularly Black Americans with cancers like multiple myeloma (MM), regarding transportation access, despite its impact on clinical outcomes and survival.
Methods: Using the National Institute on Minority Health and Health Disparities research framework, we conducted a qualitative study from November 2021 to April 2022. Twenty-one PT-informal caregiver (CG) dyads (42 participants) from the Lineberger Comprehensive Cancer Center participated in semistructured interviews. These interviews allowed participants to discuss their experiences with MM-related health issues. We used ATLAS.ti v9 for project management and data analysis using the Sort and Sift, Think and Shift approach by ResearchTalk Inc. All participants completed a sociodemographic survey.
Results: The average age of participants was 68 ± 10.13 years, with half identifying as Black and 53% as female. Three themes emerged related to health care access and transportation: (1) individual factors, including attitudes toward transportation; (2) interpersonal factors, such as reliance on CGs, family, or friends; and (3) organizational factors, such as high parking costs and structural barriers limiting access. Participants primarily recommended solutions aimed at addressing financial challenges and improving accessibility.
Conclusion: Older adults with MM and their CGs face complex transportation challenges when accessing cancer care, including high travel-related expenses, limited parking options with accessibility concerns, and long travel times. Addressing these issues requires multilevel interventions, such as including transportation coverage in health insurance and improving infrastructure, especially in underserved areas. Community solutions like volunteer driver programs and expanded telehealth can also help. Further research is needed to refine these solutions and assess their impact on health equity.
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