| Abstrakt: |
Background: Patient navigation can be resource intensive when working on the often-complex needs of underserved patients with cancer. Our nonclinical population health navigator (PHN) program was developed to address the inequities underserved populations often face during cancer. With limited resources, programs need to optimize navigation services based on patient population needs. Objectives: To (1) understand the potential association between time spent on navigator-patient interactions and navigation characteristics, such as the population of focus, type of interaction, and acuity score; and (2) improve systematic allocation of resources and better adjust caseloads among navigators for more equitable distribution. Methods: PHNs for adolescent and young adult (AYA), African American (AA), Hispanic, and rural patients document each patient interaction, including the type of interaction and time spent, as well as patient characteristics and potential barriers. An acuity scale is also utilized to pre-identify navigation needs and stratify care based on patient characteristics and barriers. Data captured by the 5 PHNs in EPIC/Healthy Planet were abstracted retrospectively from July 1, 2022, to March 31, 2023, for analysis. Data are reported in the aggregate. Results: In this cohort of 438 patients (AYA, n=85; AA, n=110; Hispanic, n=108; rural, n=135) spanning 1583 patient interactions, 79.6% lasted 30 minutes if the patient was female versus male (55% vs 45%, respectively) or self-identified as Hispanic (52%). The acuity level (no, low, medium, high) is based on the acuity score, and the majority of patients were low (49%) or medium (43%). Patients with a high level of acuity were more likely to have interactions >30 minutes. Patients navigated by the AA PHN were more likely to have interactions >30 minutes (40%), and those navigated by the rural PHN were more likely to have interactions <30 minutes (95%). Conclusion: Understanding the effort and time needed to identify populations at risk, establish priorities, and address barriers is critical to maximizing patient navigation and, ultimately, to increasing cancer health equity. If certain patient populations have more barriers and higher acuity scores, and are therefore more intensive to navigate, management of navigation resources can contribute to ameliorating disparities and improving outcomes. Further evaluation of the correlation between time intensity, patient barriers, and acuity scores for the refinement of caseload management and the development of systems-level interventions is warranted. [ABSTRACT FROM AUTHOR] |
