The Role of Legislation and Practitioner Perceptions on the Availability of Patient Navigation Programs (original) (raw)
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The Oncologist, 2018
Background Interventions aimed at improving access to timely cancer care for patients in low- and middle-income countries (LMIC) are urgently needed. We aimed to evaluate a patient navigation (PN) program to reduce referral time to cancer centers for underserved patients with a suspicion or diagnosis of cancer at a public general hospital in Mexico City. Materials and Methods From January 2016 to March 2017, consecutive patients aged >18 years with a suspicion or diagnosis of cancer seen at Ajusco Medio General Hospital in Mexico City who required referral to a specialized center for diagnosis or treatment were enrolled. A patient navigator assisted patients with scheduling, completing paperwork, obtaining results in a timely manner, transportation, and addressing other barriers to care. The primary outcome was the proportion of patients who obtained a specialized consultation at a cancer center within the first 3 months after enrollment. Results Seventy patients (median age 54, ...
Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health, 2013
Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1-83), and the median number ...
Establishing effective patient navigation programs in oncology
Supportive Care in Cancer, 2019
Purpose Recent advances in cancer treatment have resulted in greatly improved survival, and yet many patients in the USA have not benefited due to poor access to healthcare and difficulty accessing timely care across the cancer care continuum. Recognizing these issues and the need to facilitate discussions on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine (NASEM) held a workshop entitled, BEstablishing Effective Patient Navigation Programs in Oncology. The purpose of this manuscript is to disseminate the conclusions of this workshop while providing a clinically relevant review of patient navigation in oncology. Design Narrative literature review and summary of workshop discussions Results Patient navigation has been shown to be effective at improving outcomes throughout the spectrum of cancer care. Work remains to develop consensus on scope of practice and evaluation criteria and to align payment incentives and policy. Conclusion Patient navigation plays an essential role in overcoming patient-and system-level barriers to improve access to cancer care and outcomes for those most in need.
Overcoming Barriers to Cancer Care Through Health Navigation Programs
Seminars in Oncology Nursing, 2008
To provide an overview of theoretical concepts in community-based, culturally tailored health navigation programs that have improved access to health care for ethnic minority populations, particularly for Asian Americans and Pacific Islanders.
Implementation factors for patient navigation program success: a qualitative study
Implementation Science Communications, 2021
Background Patient navigation (PN) is an evidence-based practice that involves assessing and addressing individual barriers to care for patients. While PN has shown effectiveness in numerous studies, designing successful, sustainable PN programs has remained challenging for many healthcare organizations. The purpose of the present study was to examine implementation factors for successful PN programs to optimize the sustainability of PN services across cancer care settings in the USA. Methods Data were collected via semi-structured interviews with PN stakeholders (n=17) from diverse cancer care settings. Thematic content analysis was conducted by deductively coding major themes based on constructs from the Exploration-Preparation-Implementation-Sustainability framework and by inductively coding emergent themes. Results Facilitators in the outer context included payer guidelines, accreditation requirements, community partnerships, and demonstrated need and demand for services. Inner ...
Dissemination of Patient Navigation Programs Across the United States
Journal of Public Health Management and Practice, 2014
Objective: To use diffusion and dissemination frameworks to describe how indicators of economic and health care disparity affect the location and type of patient navigation programs. Methods: A cross-sectional national Web-based survey conducted during 2009-2010 with support from 65 separate national and regional stakeholder organizations. Participants: A total of 1116 self-identified patient navigators across the United States. Main Outcome Measure: The location and characteristics of patient navigation programs according to economic and health care disparity indicators. Results: Patient navigation programs appear to be geographically dispersed across the United States. Program differences were observed in navigator type, population served, and setting by poverty level. Programs in high-poverty versus low-poverty areas were more likely to use lay navigators (P < .001) and to be located in community health centers and agencies with religious affiliations (50.6 vs 36.4%, and 21.5% vs 16.7%. respectively; P ≤ 0.01). Conclusion(s): Results suggest that navigation programs have spread beyond initial target inception areas and also serve as a potentially important resource in communities with higher levels of poverty and/or relatively low access to care. In addition, while nurse navigators have emerged as a significant component of the patient navigation workforce, lay health navigators serve a vital role in underserved communities. Other factors from dissemination frameworks may influence the spread of navigation and provide useful insights to support the dissemination of programs to areas of high need.
Cancer, 2009
Background-Patient navigators--individuals who assist patients through the healthcare system to improve access to and understanding of their health and health care-are increasingly utilized for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost effective.
Cancer Patient Navigator Tasks across the Cancer Care Continuum
Journal of Health Care for the Poor and Underserved, 2012
Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services.
Consensus Support for the Role of Patient Navigation in the Nation’s Healthcare System
Patient Navigation, 2017
Patient Navigation was developed as an intervention to improve outcomes among medically underserved populations by addressing barriers to completing a health care goal [1]. As Patient Navigation underwent widespread implementation, both its definition and practice evolved to address diverse patient populations and needs, by various workforce members, in numerous settings. This chapter is intended to create a common understanding of Patient Navigation and the role it can play in the healthcare system. It is aimed mainly at supporting recommendations for healthcare policy changes (e.g., staffing) and also provides a framework for building broad support for support for Patient Navigators across the healthcare delivery system.
Journal of oncology navigation & survivorship, 2012
Cancer patients face a myriad of psychosocial and practical issues. Especially challenging is the time from an initial diagnosis to the onset of treatment and patient navigation services are important to guide patients, especially underserved populations, through this maze of uncertainty. Here we report on the Pennsylvania Patient Navigator Demonstration Project (PaPND) designed to evaluate the acceptability, feasibility, and impact of a culturally and linguistically appropriate non-clinical navigator program. The development of the project, based on behavioral theory and community-based participatory research principles, is described. Forty-four cancer patients from diverse backgrounds participated, which included a baseline assessment, navigation services, and a four week and twelve week follow-up assessment. On average, participants experienced 1.8 barriers with transportation and insurance issues the most common barriers. The majority (56%) of the barriers required more than an ...