Access to Quality Cancer Care
Cancer is the second most common cause of death in the United States. According to the American Cancer Society (2015), about 78% of all cancer diagnoses are in people aged 55 years or older. Access to quality cancer care is the right of all people. Quality care requires safety, efficacy, timeliness, a patient-centered approach coordinated by a multidisciplinary team, and the integration of evidence-based practice to continuously improve care (Institute of Medicine, 2010). Without essential services targeted at reducing cancer risk, morbidity, and mortality, patients with cancer may suffer from decreased quality of life or less-than-optimal outcomes. Those services are prevention, early detection, risk reduction, clinical trials, treatment, palliative care, psychosocial care, survivorship, and end-of-life care.
Healthcare coverage, including Medicare and the 2010 Affordable Care Act, is essential in providing access to services that ensure quality cancer care. Lack of insurance or inadequate healthcare coverage adversely affects health on multiple levels. Uninsured individuals are less likely to receive preventive care and more likely to receive inadequate or delayed treatment and die prematurely than those with health insurance coverage.
To ensure quality cancer care, the Oncology Nursing Society affirms the substantive role of oncology nurses in decision making and the integration of oncology nursing as an equal administrative and practice partner in the planning and implementation of cancer care services.
It is the position of ONS that
- The provision of comprehensive healthcare coverage with respect to cancer prevention, cancer risk assessment, risk reduction services, genetic counseling, genetic predisposition testing, early detection, and screening procedures is available to everyone through continuous health insurance coverage, irrespective of personal or family health history or preexisting conditions.
- The provision of accessible and affordable healthcare coverage includes consumer and patient engagement in decision making regarding availability, cost, and efficacy of treatment options and supportive care.
- Evidence-based conventional and integrative therapies, including regimens incorporating the use of off-label therapies approved by the U.S. Food and Drug Administration for other indications, comprehensive symptom management and palliative care, psychosocial care, and survivorship are options for every patient with cancer.
- All individuals have affordable access to the full range of tobacco cessation strategies and therapies that have been proven to be effective.
- Services provided by professional oncology nurses who are competent in the essentials of oncology nursing and the administration of oncologic therapies, comprehensive patient and family education, palliative care, and adherence monitoring, and the services provided by advanced practice oncology nurses competent in providing treatment to those with cancer, particularly the prevention and management of treatment-related toxicities, are accessible and eligible for reimbursement.
- Oncology nurses in all practice settings, irrespective of educational background, identify patient access barriers and potential solutions to provide quality oncology patient care.
- Health disparities, such as lack of access to appropriate cancer screening or care, which results in higher rates of advanced disease at diagnosis, poorer outcomes, and higher overall death rates, are addressed for at-risk and underserved populations, and appropriate referrals are made to community resources.
- Everyone, regardless of age, gender, race, or ethnicity, has the opportunity to participate in clinical trials for cancer prevention and comprehensive cancer care, including those coordinated by nurses educated and certified in oncology nursing, allowing for continuing informed consent, patient education, and advocacy.
Approved by the ONS Board of Directors, March 2012. Reviewed January 2013, January 2014, January 2015, January 2016.
American Cancer Society. (2014). Cancer facts and figures 2013. Retrieved from http://www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2013/index
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx