TABLE 3.
Respondents’ Perceptions of Patients Who Self-Refer for Oncology Treatment Abroad
| Variable | N | Rating | ||||||
|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | ||
| Reasons why patients self-refer for treatment abroad rather than receive treatment locally from most common (1) to least common (7) | ||||||||
| Mistrust in system | 42 | 12 (28.6) | 10 (23.8) | 8 (19.0) | 3 (7.1) | 4 (9.5) | 4 (9.5) | 1 (2.4) |
| Solicitation from referral system abroad | 40 | 2 (5.0) | 2 (5.0) | 11 (27.5) | 8 (20.0) | 7 (17.5) | 6 (15.0) | 4 (10.0) |
| Perception of higher quality of care abroad | 43 | 25 (58.1) | 10 (23.3) | 3 (7.0) | 2 (4.7) | — | — | 3 (7.0) |
| Perception of better provider communication abroad | 42 | 5 (11.9) | 6 (14.3) | 6 (14.3) | 9 (21.4) | 9 (21.4) | 7 (16.7) | — |
| Fear of stigma | 41 | 1 (2.4) | 3 (7.3) | 5 (12.2) | 5 (12.2) | 9 (22.0) | 13 (31.7) | 5 (12.2) |
| Social prestige or affluence associated with international treatment | 41 | 6 (14.6) | 7 (17.1) | 12 (29.3) | 6 (14.6) | 5 (12.2) | 3 (7.3) | 2 (4.9) |
| Lower cost of services abroad | 41 | 3 (7.3) | 1 (2.4) | — | 2 (4.9) | 2 (4.9) | 5 (12.2) | 28 (68.3) |
| Cancer type with the most unwarranted self-referrals (1) to cancer type with the fewest (6) | 1 | 2 | 3 | 4 | 5 | 6 | ||
| Breast self-referrals | 43 | 21 (48.8) | 9 (20.9) | 5 (11.6) | 1 (2.3) | 4 (9.3) | 3 (7.0) | — |
| Colorectal self-referrals | 43 | 4 (9.3) | 12 (27.9) | 11 (25.6) | 6 (14.0) | 8 (18.6) | 2 (4.7) | — |
| Cervix self-referrals | 43 | 2 (4.7) | 8 (18.6) | 4 (9.3) | 1 (2.3) | 6 (14.0) | 22 (51.2) | — |
| Prostate self-referrals | 43 | 7 (16.3) | 8 (18.6) | 10 (23.3) | 9 (20.9) | 5 (11.6) | 4 (9.3) | — |
| Head and neck self-referrals | 43 | 4 (9.3) | 5 (11.6) | 5 (11.6) | 8 (18.6) | 13 (30.2) | 8 (18.6) | — |
| Hematological malignancies self-referrals | 43 | 11 (25.6) | 5 (11.6) | 2 (4.7) | 7 (16.3) | 6 (14.0) | 12 (27.9) | — |
| Challenges patients face when self-referring (1 being the greatest challenge and 7 being the smallest) | ||||||||
| Receiving lower quality care | 42 | 3 (7.1) | 2 (4.8) | 1 (2.4) | 5 (11.9) | 7 (16.7) | 5 (11.9) | 19 (45.2) |
| Aggressive, unwarranted treatment | 43 | 7 (16.3) | 5 (11.6) | 11 (25.6) | 7 (16.3) | 5 (11.6) | 7 (16.3) | 1 (2.3) |
| Overuse of tests | 43 | 12 (27.9) | 11 (25.6) | 5 (11.6) | 3 (7.0) | 6 (14.0) | 5 (11.6) | 1 (2.3) |
| Expenses—treatment, travel, accommodation | 45 | 33 (73.3) | 4 (8.9) | 3 (6.7) | 1 (2.2) | 1 (2.2) | 1 (2.2) | 2 (4.4) |
| Loss of continuity of care | 43 | 6 (14.0) | 11 (25.6) | 11 (25.6) | 7 (16.3) | 4 (9.3) | 2 (4.7) | 2 (4.7) |
| Loss of valuable time | 44 | 2 (4.5) | 6 (13.6) | 6 (13.6) | 6 (13.6) | 13 (29.5) | 8 (18.2) | 3 (6.8) |
| Poor outcomes/complications of treatment from inadequate follow-up | 44 | 3 (6.8) | 4 (9.1) | 5 (11.4) | 7 (15.9) | 7 (15.9) | 9 (20.5) | 9 (20.5) |