Evaluation of a Novel Financial Navigator Pilot to Address Patient Concerns about Medical Care Costs.

Autor:	Banegas MP; Kaiser Permanente Center for Health Research, Portland, OR.; Kaiser Permanente Northwest, Portland, OR., Dickerson JF; Kaiser Permanente Center for Health Research, Portland, OR.; Kaiser Permanente Northwest, Portland, OR., Friedman NL; Kaiser Permanente Center for Health Research, Portland, OR.; Kaiser Permanente Northwest, Portland, OR., Mosen D; Kaiser Permanente Center for Health Research, Portland, OR.; Kaiser Permanente Northwest, Portland, OR., Ender AX; Kaiser Permanente Northwest, Portland, OR., Chang TR; Kaiser Permanente Northwest, Portland, OR., Runge TA; Kaiser Permanente Northwest, Portland, OR., Hornbrook MC; Kaiser Permanente Northwest, Portland, OR.
Jazyk:	angličtina
Zdroj:	The Permanente journal [Perm J] 2019; Vol. 23.
DOI:	10.7812/TPP/18-084
Abstrakt:	Context: Interventions are required that address patients' medically related financial needs. Objective: To evaluate a Financial Navigator pilot addressing patients' concerns/needs regarding medical care costs in an integrated health care system. Methods: Adults (aged ≥ 18 years) enrolled at Kaiser Permanente Northwest, who had a concern/need about medical care costs and received care in 1 of 3 clinical departments at the intervention or comparison clinic were recruited between August 1, 2016, and October 31, 2016. Baseline and 30-day follow-up participant surveys were administered to assess medical and nonmedical socioeconomic needs, satisfaction with medical care, and satisfaction with assistance with cost concerns. Physicians at both clinics were invited to complete a survey on medical care costs. We assessed participant characteristics and survey responses using descriptive statistics and 30-day change in satisfaction measures using multivariable linear regression models. Results: Eighty-five intervention and 51 comparison participants completed the baseline survey. At baseline, intervention participants reported transportation (52.9%), housing (38.2%), and social isolation (32.4%) needs; comparison participants identified employment (33.3%), food (33.3%), and housing (33.3%) needs. Intervention participants reported higher satisfaction with care (p = 0.01) and higher satisfaction with cost concerns assistance (p = 0.01) vs comparison participants at 30-day follow-up, controlling for baseline responses. Although most physicians (80%) reported discussing medical care costs with their patients, only 18% reported knowing about their patients' financial well-being. Conclusion: We demonstrated the promise of a novel Financial Navigator pilot intervention to address medical care cost concerns and needs, and underscored the prevalence of nonmedical social needs in an economically vulnerable population.
Databáze:	MEDLINE
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