Pursuing cancer treatment across the US-Mexico border: Motivations and barriers.

Abstract

e18575 Background: Healthcare utilization is a common reason for bidirectional travel across the US-Mexico border. We surveyed Mexican oncologists to understand why patients with cancer in the US and Mexico seek care outside their home country and what barriers they face. Methods: Approval was obtained from Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán´s IRB. Oncologists living in Mexican border states (Baja California, Sonora, Chihuahua, Coahuila, Nuevo León, and Tamaulipas) were identified from the Mexican Society of Oncology’s directory. Two hundred twenty-five participants were queried via e-mail with a REDCap survey designed by the investigators. Descriptive statistics were used to analyze responses. Results: Sixty-six respondents completed the survey, most of whom were medical (n = 24) or surgical oncologists (n = 24) who had practiced for < 5 years (n = 31). Sixty (90.9%) respondents interacted with US-based patients who traveled to Mexico to receive care, most frequently due to inadequate health insurance (n = 45). Forty-eight (72.7%) respondents interacted with Mexico-based patients who traveled to the US to receive care, most frequently due to patient perception of superior care in the US (n = 38). Table 1 describes the reported reasons patients traveled across the border for cancer care. Twenty-nine (43.9%) respondents interacted with US-based patients who wanted to receive care in Mexico but could not, most frequently due to lack of financial resources (n = 17) or of a support system in Mexico (n = 10). Forty-three (65.2%) respondents interacted with Mexico-based patients who wanted to receive care in the US but could not, most frequently due of lack of financial resources (n = 43) or passport/visa issues (n = 14). Conclusions: According to Mexican oncologists, US-based patients travel to Mexico to receive cancer care primarily due to inadequate health insurance. In contrast, Mexico-based patients travel to the US primarily due to their perception that care in the US is of higher quality and because aspects of their care are unavailable in Mexico. Both US and Mexico-based patients face many barriers to receiving care outside their home country, which should be tackled to improve access to quality care in border region. [Table: see text]