Exploring Barriers and Inequalities in Access to Comprehensive Care for Pediatric Oncology Patients: A Systematic Review.

Objectives: This systematic review aimed to explore and synthesize existing research on the barriers and inequalities in access to comprehensive care for pediatric oncology patients.

Methods: The search was conducted in five databases, including PubMed, Scopus, Web of Science, CINAHL, and APA PsycINFO in December 2024. This review followed PRISMA guidelines and included studies published up to December 2024. Study quality was assessed using Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields.

Results: Thirteen articles in this systematic reviews identified key barriers to healthcare access, including inadequate infrastructure, workforce shortages, and financial constraints. Socioeconomic disparities, geographic inequities, and racial and ethnic inequalities further exacerbated these challenges. Lower family income was linked to worse outcomes, such as higher chronic graft-versus-host disease rates and late-stage cancer diagnoses. Cross-border residency, clinical trial underrepresentation, and insufficient clinician training also contributed to disparities. Proposed solutions included psychosocial screening, workforce development, financial toxicity mitigation, and policy reforms.

Conclusions: This review highlights the complex and multifaceted barriers affecting equitable access to comprehensive care for pediatric oncology patients. Using a multidimensional perspective, such as the National Institute on Minority Health and Health Disparities Research Framework, our findings suggest that disparities stem from interconnected social, economic, and systemic factors. Addressing these challenges requires a comprehensive, structural, and patient-centered approach to promote equitable healthcare access.

Implications for nursing practice: This review underlines the critical role of nursing advocacy, education, and interdisciplinary collaboration in promoting equitable care and addressing disparities within this vulnerable population.