Healthcare Access and Utilization in a National Sample of Cancer Survivors With a History of Military Service.
In a national observational sample of 18,678 veterans with cancer, women, adults aged 18–44 years, and lower-income participants disproportionately reported barriers to healthcare access and utilization.
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In a national observational sample of 18,678 veterans with cancer, women, adults aged 18–44 years, and lower-income participants disproportionately reported barriers to healthcare access and utilization.
Research significance
The evidence identifies demographic and socioeconomic groups with greater access barriers; it may support testing targeted navigation, financial assistance, transportation, or caregiving-support interventions, but the record does not evaluate any intervention or demonstrate improved cancer outcomes.
Source abstract
OBJECTIVES: To identify healthcare access and utilization (HCAU) needs in a national sample of veterans with cancer. SAMPLE AND SETTING: This study includes participants in the All of Us Research Program who reported a history of military service and a diagnosis of cancer. METHODS AND VARIABLES: This secondary analysis includes demographics, electronic health record-confirmed cancer, and HCAU variables (transportation, duties and responsibilities, healthcare attitudes, general healthcare cost, vision or dental cost, medication cost, and mental healthcare cost). RESULTS: The sample included 18,678 veterans. Women comprised 19% of the sample but reported barriers across domains more frequently than men (transportation: 12% vs. 6%; duties and responsibilities: 16% vs. 6%, and mental healthcare cost: 41% vs. 21%). Veterans aged 18-44 years comprised 12% of the sample but 40% of those struggling to manage health care while maintaining duties and responsibilities (time off work, child care, elder care). Veterans in the lowest income bracket comprised 27% of the sample and reported barriers across domains (51% of those reporting difficulties with transportation, and about one-third of those reporting barriers in all other HCAU domains). IMPLICATIONS FOR NURSING: This study identified gaps in HCAU for veterans with cancer and provides important information on those at highest risk, including veterans who are female, who are younger, and with lower incomes. These results will inform future studies in this vulnerable population.