219594 Reducing barriers to care through patient navigation

Monday, November 8, 2010 : 12:30 PM - 12:45 PM

Patricia Valverde, MPH , Colorado School of Public Health, University of Colorado Denver, Aurora, CO
William Thorland, PhD , Department of Hematology/Oncology, Denver Health, Denver, CO
Elizabeth Whitley, RN, PHD , Project Director, Dnever Health Community Volices, Denver, CO
Peter Raich, MD, FACP , Department of Hematology/Oncology, Denver Health and Hospital Authority, Denver, CO
     
Patient navigation assists patients with overcoming barriers to healthcare access and adherence to plans of care. Medically underserved populations experience greater numbers of barriers, which may contribute to increased rates of mortality and morbidity. The Patient Navigation Research Program was initiated in 2006 to evaluate the impact of patient navigation on time to resolution of abnormal cancer screening and time to initiation of treatment upon breast, colorectal, cervix or prostate cancer diagnosis. In Denver, participants were randomized to the navigation or the non-navigation control arm, and all patients were monitored through either resolution of the abnormal screening test or the completion of cancer treatment. We assessed the frequency of 22 barriers experienced by participants during 12 months prior to study enrollment and again at 3 months following resolution of screening or after initiation of cancer treatment (n=285). We found statistically significant lower rates of 4 of the 5 most common barriers in navigated patients diagnosed with cancer, while no improvement was seen for these 4 barriers in non-navigated cancer patients. The 4 barriers included: feeling overwhelmed (69 vs. 42%, p=.03), financial concerns (59 vs. 25% p=.01), transportation (44 vs. 19%, p=.02), and making medical appointments (41 vs. 16%, p=.01). Patients diagnosed with cancer face many barriers that impede their ability to access and complete treatment. Our results show that a patient navigator for such patients is effective in reducing major barriers to care.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
1. By the end of this session, the learner will name the main barriers experienced by low-income publicly-insured or uninsured patients when accessing health services. 2. The learner will be able to name three specific areas in which a patient navigator assists cancer patients through the continuum of their care.

Keywords: Health Disparities, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I manage the day to day operations of the Denver Health patient navigator research program. I have developed, managed and evaluated patient navigator programs for well over 8 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3229.1: Patient Navigation to Address Cancer Health Disparities: Preliminary Results of the Cancer Navigator Research Program (organized jointly by the Cancer Forum and Medical Care)