Childhood cancer survivors’ utilization of primary care provider services and barriers to primary care

Abstract

This cross-sectional study explores the types of preventive and chronic care survivors of childhood cancer and pediatric bone marrow transplant receive from their primary care providers. We also identified barriers perceived by survivors to utilization of primary care. Survivors were recruited from a large Midwestern pediatric hospital and completed a demographic and an eight-item semi-structured survey. Parents of survivors <18 years completed the survey for their child and survivors >18 years completed on their own. A total of 259 caregivers (55.7%) and 206 survivors (44.3%) participated. The mean survivor age was 19.76 (SD = 8.89). Most survivors reported having a PCP (n = 400, 87.1%). A subset of survivors self-reported visiting a PCP for chronic care (n = 79, 16.7%). Most common reasons for not having a PCP included unsure who to see (n = 27, 52.9%) and lack of insurance (n = 10, 19.6%). Annual family income (β = 1.53, 95% CI [1.26, 1.86]) and healthcare insurance (β = 6.02, 95%CI [1.25, 29.08]) were predictive of having a PCP. Despite having a PCP, few survivors visited them for chronic care. Interventions are needed to facilitate the transition of survivors to a PCP for management of chronic conditions after their cancer treatment.