BACKGROUND: This report details the cost effectiveness of a non-nurse patient navigation (PN) program that was implemented at the University of Chicago Medical Center to increase colonoscopy-based colorectal cancer (CRC) screening. METHODS: The authors investigated the impact of the PN intervention by collecting process measures. Individuals who received navigation were compared with a historic cohort of non-navigated patients. In addition, a previously validated data-collection instrument was tailored and used to collect all costs related to developing, implementing, and administering the program; and the incremental cost per patient successfully navigated (the cost of the intervention divided by the change in the number who complete screening) was calculated. RESULTS: The screening colonoscopy completion rate was 85.1% among those who were selected to receive PN compared with 74.3% when no navigation was implemented. With navigation, the proportion of no-shows was 8.2% compared with 15.4% of a historic cohort of non-navigated patients. Because the perceived risk of noncompletion was greater among those who received PN (previous no-show or cancellation, poor bowel preparation) than that in the historic cohort, a scenario analysis was performed. Assuming no-show rates between 0% and 50% and using a navigated rate of 85%, the total incremental program cost per patient successfully navigated ranged from $148 to $359, whereas the incremental intervention-only implementation cost ranged from $88 to $215. CONCLUSIONS: The current findings indicate that non-nurse PN can increase colonoscopy completion, and this can be achieved at a minimal incremental cost for an insured population at an urban academic medical center.
BACKGROUND: This report details the cost effectiveness of a non-nurse patient navigation (PN) program that was implemented at the University of Chicago Medical Center to increase colonoscopy-based colorectal cancer (CRC) screening. METHODS: The authors investigated the impact of the PN intervention by collecting process measures. Individuals who received navigation were compared with a historic cohort of non-navigated patients. In addition, a previously validated data-collection instrument was tailored and used to collect all costs related to developing, implementing, and administering the program; and the incremental cost per patient successfully navigated (the cost of the intervention divided by the change in the number who complete screening) was calculated. RESULTS: The screening colonoscopy completion rate was 85.1% among those who were selected to receive PN compared with 74.3% when no navigation was implemented. With navigation, the proportion of no-shows was 8.2% compared with 15.4% of a historic cohort of non-navigated patients. Because the perceived risk of noncompletion was greater among those who received PN (previous no-show or cancellation, poor bowel preparation) than that in the historic cohort, a scenario analysis was performed. Assuming no-show rates between 0% and 50% and using a navigated rate of 85%, the total incremental program cost per patient successfully navigated ranged from $148 to $359, whereas the incremental intervention-only implementation cost ranged from $88 to $215. CONCLUSIONS: The current findings indicate that non-nurse PN can increase colonoscopy completion, and this can be achieved at a minimal incremental cost for an insured population at an urban academic medical center.
Authors: Daniel S Reuland; Alison T Brenner; Richard Hoffman; Andrew McWilliams; Robert L Rhyne; Christina Getrich; Hazel Tapp; Mark A Weaver; Danelle Callan; Laura Cubillos; Brisa Urquieta de Hernandez; Michael P Pignone Journal: JAMA Intern Med Date: 2017-07-01 Impact factor: 21.873
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Authors: Sujha Subramanian; Florence K L Tangka; Sonja Hoover; Maggie C Beebe; Amy DeGroff; Janet Royalty; Laura C Seeff Journal: Cancer Date: 2013-08-01 Impact factor: 6.860
Authors: Lina Jandorf; Lauren M Stossel; Julia L Cooperman; Joshua Graff Zivin; Uri Ladabaum; Diana Hall; Linda D Thélémaque; William Redd; Steven H Itzkowitz Journal: Cancer Date: 2012-07-25 Impact factor: 6.860
Authors: Amy DeGroff; Paul C Schroy; Kerry Grace Morrissey; Beth Slotman; Elizabeth A Rohan; James Bethel; Jennifer Murillo; Weijia Ren; Shelley Niwa; Steven Leadbetter; Djenaba Joseph Journal: Am J Prev Med Date: 2017-07-01 Impact factor: 5.043
Authors: Sujha Subramanian; Sonja Hoover; Florence K L Tangka; Amy DeGroff; Cynthia S Soloe; Laura C Arena; Dara F Schlueter; Djenaba A Joseph; Faye L Wong Journal: Cancer Date: 2018-10-25 Impact factor: 6.860
Authors: Karen E Kim; Florence K L Tangka; Manasi Jayaprakash; Fornessa T Randal; Helen Lam; David Freedman; Laurie A Carrier; Coletta Sargant; Chieko Maene; Sonja Hoover; Djenaba Joseph; Cynthia French; Sujha Subramanian Journal: Health Promot Pract Date: 2020-09-29
Authors: Meghan C O'Leary; Kristen Hassmiller Lich; Leah Frerichs; Jennifer Leeman; Daniel S Reuland; Stephanie B Wheeler Journal: Implement Sci Date: 2022-04-15 Impact factor: 7.960