Rebecca Luckett1, Nancy Pena2, Allison Vitonis1, Marilyn R Bernstein2, Sarah Feldman1. 1. 1 Department of Obstetrics and Gynecology, Brigham and Women's Hospital , Boston, Massachusetts. 2. 2 Department of Gynecologic Oncology, Dana Farber Cancer Institute , Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: Patient navigators have been used successfully to guide vulnerable patients through barriers to cancer care and reduce disparities in cancer outcomes. This study evaluated the effect of a patient navigator program on no-show rates at a tertiary care referral colposcopy center and explored factors associated with missed appointments. METHODS: No-show rates prior and subsequent to implementation of the intervention were compared by chi-square test. We compared patient demographic, lifestyle, and diagnostic characteristics between patients who had ever and never missed appointments. We described patient-reported barriers to care. RESULTS: Of 4,199 women evaluated in our clinic from January 2006 to December 2013, 2,441 (58%) had at least one missed appointment. African American, Hispanic, and publicly insured women tended to miss appointments more frequently than did white and privately insured women (p<0.0001). Patients who missed appointments tended to have more abnormal cytology (p<0.0001), cervical pathology (p=0.007), and vulvar pathology (p=0.001). No-show rates declined from 49.7% to 29.5% after implementation of the patient navigator program (p<0.0001). We found that 45% of patient no-shows were anticipated or a result of patient misunderstanding and could be mediated with targeted education by the patient navigator. CONCLUSIONS: Patient navigator programs at referral centers reduce no-show rates, thus improving patient follow-up, which may reduce disparities in cervical cancer screening and treatment.
BACKGROUND:Patient navigators have been used successfully to guide vulnerable patients through barriers to cancer care and reduce disparities in cancer outcomes. This study evaluated the effect of a patient navigator program on no-show rates at a tertiary care referral colposcopy center and explored factors associated with missed appointments. METHODS: No-show rates prior and subsequent to implementation of the intervention were compared by chi-square test. We compared patient demographic, lifestyle, and diagnostic characteristics between patients who had ever and never missed appointments. We described patient-reported barriers to care. RESULTS: Of 4,199 women evaluated in our clinic from January 2006 to December 2013, 2,441 (58%) had at least one missed appointment. African American, Hispanic, and publicly insured women tended to miss appointments more frequently than did white and privately insured women (p<0.0001). Patients who missed appointments tended to have more abnormal cytology (p<0.0001), cervical pathology (p=0.007), and vulvar pathology (p=0.001). No-show rates declined from 49.7% to 29.5% after implementation of the patient navigator program (p<0.0001). We found that 45% of patient no-shows were anticipated or a result of patient misunderstanding and could be mediated with targeted education by the patient navigator. CONCLUSIONS:Patient navigator programs at referral centers reduce no-show rates, thus improving patient follow-up, which may reduce disparities in cervical cancer screening and treatment.
Authors: Lynn M Yee; Brittney Williams; Hannah M Green; Viridiana Carmona-Barrera; Laura Diaz; Ka'Derricka Davis; Michelle A Kominiarek; Joe Feinglass; Chloe A Zera; William A Grobman Journal: Am J Obstet Gynecol Date: 2021-04-01 Impact factor: 10.693
Authors: Maelys Amat; Rebecca Glassman; Nisha Basu; Jim Doolin; Lydia Flier; Mariana R Gonzalez; Jeanne Gosselin; Sarah Knapp; Phillip Yun; Kelly L Graham Journal: J Gen Intern Med Date: 2021-01-21 Impact factor: 6.473
Authors: Whitney L Hensing; Steven P Poplack; Cheryl R Herman; Siobhan Sutcliffe; Graham A Colditz; Foluso O Ademuyiwa Journal: Cancer Date: 2021-04-01 Impact factor: 6.921