Patient Perception and Cost-Effectiveness of a Patient Navigation Program to Improve Breast Cancer Screening for Hispanic Women.

Autor:	Li Y; Center for Health Innovation, The New York Academy of Medicine, New York, New York.; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York., Carlson E; College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas., Hernández DA; College of Architecture, Planning and Public Affairs, The University of Texas at Arlington, Arlington, Texas., Green B; College of Architecture, Planning and Public Affairs, The University of Texas at Arlington, Arlington, Texas., Calle T; Williams College, Williamstown, Massachusetts., Kumaresan T; Union College, Schenectady, New York., Madondo K; Center for Health Innovation, The New York Academy of Medicine, New York, New York.; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York., Martinez M; Research and Information Management, University Health System, San Antonio, Texas., Villarreal R; Research and Information Management, University Health System, San Antonio, Texas., Meraz L; Research and Information Management, University Health System, San Antonio, Texas., Pagán JA; Center for Health Innovation, The New York Academy of Medicine, New York, New York.; Department of Public Health Policy and Management, College of Global Public Health, New York University, New York, New York.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Health equity [Health Equity] 2019 Jun 20; Vol. 3 (1), pp. 280-286. Date of Electronic Publication: 2019 Jun 20 (Print Publication: 2019).
DOI:	10.1089/heq.2018.0089
Abstrakt:	Purpose: Hispanic women are less likely to be screened for breast cancer than non-Hispanic women, which contributes to the disproportionate prevalence of advanced-stage breast cancer in this population group. Patient navigation may be a promising approach to help women overcome the complexity of accessing multiple health care services related to breast cancer screening and treatment. The goal of this study is to assess patient perception and cost-effectiveness of a multilevel, community-based patient navigation program to improve breast cancer screening among Hispanic women in South Texas. Methods: We used mixed methods-including focus groups of program participants and a microsimulation model of breast cancer-to evaluate the effectiveness and cost-effectiveness of the program on the target population. Program data from 2013 to 2016 were collected and used to conduct the analyses. Results: Focus groups showed that the patient navigation program improved patient knowledge, attitudes, and behaviors regarding breast health and increased the mammography screening rate from 60% to 80%. Cost-effectiveness analysis showed that the program could increase life expectancy by 0.71 years and yield an incremental cost-effectiveness ratio of $3120 per quality-adjusted life year compared to no intervention. Conclusion: The 3-year multilevel, community-based patient navigation program effectively increased mammography screening uptake and adherence and improved knowledge and behaviors on breast health among program participants. Future research is needed to translate and disseminate the program to other socioeconomic and demographic groups to test its robustness and design. Competing Interests: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.
Databáze:	MEDLINE
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