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- Title
Patient Navigation to Enhance Access to Care for Underserved Patients with a Suspicion or Diagnosis of Cancer.
- Authors
Chavarri‐Guerra, Yanin; Soto‐Perez‐de‐Celis, Enrique; Ramos‐López, Wendy; San Miguel de Majors, Sandra L.; Sanchez‐Gonzalez, Jesus; Ahumada‐Tamayo, Samuel; Viramontes‐Aguilar, Lorena; Sanchez‐Gutierrez, Oscar; Davila‐Davila, Bernardo; Rojo‐Castillo, Patricia; Perez‐Montessoro, Viridiana; Bukowski, Alexandra; Goss, Paul E.
- Abstract
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, range 19–85) participated in this study. Ninety‐six percent (n = 67) identified >1 barrier to cancer care access. The most commonly reported barriers to health care access were financial burden (n = 50) and fear (n = 37). Median time to referral was 7 days (range 0–49), and time to specialist appointment was 27 days (range 1–97). Ninety‐one percent of patients successfully obtained appointments at cancer centers in <3 months. Conclusion: Implementing PN in LMIC is feasible, and may lead to shortened referral times for specialized cancer care by helping overcome barriers to health care access among underserved patients. Implications for Practice: A patient navigation program for patients with suspicion or diagnosis of cancer in a second‐level hospital was feasible and acceptable. It reduced patient‐reported barriers, and referral time to specialized appointments and treatment initiation were within international recommended limits. Patient navigation may improve access to care for underserved patients in developing countries. Innovative strategies aimed at achieving timely referrals for patients with cancer, particularly those with limited resources, are needed. One such strategy is patient navigation (PN), which is a coordinated process of assistance that helps patients overcome personal and system barriers to obtain timely care. This article reports the results of a study designed to evaluate an evidence‐based and culturally sensitive PN program aimed at reducing the time to referral to a cancer center for patients with a suspicion or a diagnosis of cancer seen at a public general hospital in Mexico.
- Subjects
MEXICO; CANCER patient medical care; CANCER patient psychology; HEALTH services accessibility; HOSPITAL wards; MEDICAL appointments; MEDICAL referrals; ONCOLOGY; QUALITY assurance; ECONOMIC status; HUMAN services programs; PATIENT-centered care; TRANSPORTATION of patients; MIDDLE-income countries; LOW-income countries; EARLY detection of cancer
- Publication
Oncologist, 2019, Vol 24, Issue 9, p1195
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2018-0133