Subthemes and illustrative quotes from interviews with providers within the Massachusetts Access Program network
| Acceptability and perceived impact | |
| (a) Positive patient experiences | “Any patient that I talk to who’s been referred to us through the Access Program, or that I’ve referred to the Access Program, says nothing but good things about how helpful they are and how accessible (the Access Coordinator) is, and is able to help them with whatever they need, or at least help them figure out how to get what they need.” |
| (b) Perceived impact on patient knowledge | “ Because they’ve already spoken with (the Access Coordinator), they have a better understanding of what the process is going to be like, so what to expect when coming to the pre-operative appointment, and then what the surgery might be like. If patients are referred from an outside provider within our area, they often don’t really have much of an idea of what to expect…” |
| (c) Perceived impact on access to care |
“…(the Access Program)’s very important, because it serves women who are in need, and it actually allows them to get abortions. When I think if the Access Program weren’t there, they might be carrying unintended pregnancies to term." “This is a way for patients that sometimes don’t have the ease of being able to easily get connected with a physician that’s able to do this procedure for them. I think that it helps take away that burden.” |
| Key Program features | |
| (d) Fundraising and resources | “I had patients who would present to us, not through the Access Program, but who had other complicated issues like funding problems, lack of insurance, things like that, and doing that myself, and trying to get funding and contacting all of the funds…is just so time consuming. And it’s so much easier to just call (the Access Coordinator) …the fact that she can just take it off my hands and I don’t have to worry about it, is so nice and saves me so much time…” |
| (e) Specialised knowledge |
“I never had before any access to the funds myself and that was helpful that (the Access Coordinator had) financial resources to help the patient.”
“To have someone who has the connections and the ability to help, to facilitate that referral to a different provider, I think it’s important. And then to be a patient, who doesn’t have all those connections…I think that (the Access Coordinator) is a great resource for these patients because there’s often issues, insurance issues, travelling, day care, a ton of different issues that come up with patients, and (the Access Coordinator) is able to find a provider in the area that will be able to serve the patient as best as possible.” “It’s like this particular clinic goes to this many weeks and they charge this amount of money, and this one will only take these funds but not those funds, and they can go to New York but then we need to figure out…there’s just a lot of different pieces and (the Access Coordinator) is so on top of it all and just understands the whole process so well.” “It just makes your life so much easier when you have someone who just really understands the process and understands different providers and different clinics and understands the different insurances and just understands all of that…” |
| (f) Network structure |
“The biggest problem around second-trimester abortion access is the limitations of where the providers are – that they’re not well geographically distributed, that there are a lot of hostile restrictions of what people can do at their places of work…The larger focus needs to be on trying to improve access to care for women. I think this program is one of those excellent patches that helps to fill over one of the holes in our system, and I think it is working as well as it can be.”
“Having such a network in place, the women who really need it most, because they’re most on a clock when it comes to needing the procedure done…, is the best way to ensure that whatever’s happening at any given hospital, or what the patient’s insurance is, or all the other barriers to getting care where you live, having a programme like this is the best way to get her care as safely and as fast as possible. Because we share, we feel these beliefs very strongly, we will stay active with the program as long as it exists.” |
| (g) Reciprocity of referrals |
“I’ve sent plenty of patients back to the Access Coordinator when I wasn’t able to help them myself here, and she’s been able to help them.”
“If I have a patient who’s complicated socially or financially, then all I have to do is call (the Access Coordinator). It’s such a nice handoff, you can just give her the scoop and she just takes care of it. Which is really nice because otherwise, if we have to send people to other places, it’s so challenging.” |