Purpose: Despite widespread reports of cancer-related financial hardship, hospital financial assistance programs are underutilized.
Approach: Rapid qualitative research.
Sample: Gynecologic oncology patients with recurrent or metastatic disease, under 65 years old, and Comprehensive Score for Financial Toxicity of 26 or under.
Methods: Semi-structured interviews to elicit (1) financial assistance awareness/knowledge, (2) barriers to accessing assistance, and (3) suggestions for improving access. We analyzed the transcripts using thematic analysis: open coding, consensus building/codebook, and identification of salient themes.
Findings: We interviewed 25 patients and identified four barriers and three suggestions for improving access. Barriers: lack of awareness, perceptions of ineligibility, fear of negative consequences, and being overwhelmed. Suggestions: simplifying financial processes, providing individualized assistance, and being more proactive by intervening earlier.
Conclusion: Increase access by reducing stigma, misconceptions, and more proactively engaging at-risk patients.
Implications for psychosocial providers: Patients may be too afraid or overwhelmed to ask for help. A more proactive, psychosocial approach is needed.
Keywords: charity care; cost of care; financial assistance; financial burden; financial hardship; financial toxicity; gynecology oncology.