Patient Navigation to Enhance Access to Care for Underserved Patients with a Suspicion or Diagnosis of Cancer
| Autor: | Bernardo Davila-Davila, Samuel Ahumada‐Tamayo, Enrique Soto-Perez-de-Celis, Oscar Sanchez‐Gutierrez, Jesus Sanchez‐Gonzalez, Viridiana Perez-Montessoro, Sandra L. San Miguel de Majors, Wendy Alicia Ramos-Lopez, Lorena Viramontes-Aguilar, Paul E. Goss, Patricia Rojo-Castillo, Yanin Chavarri-Guerra, Alexandra Bukowski |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research Global Health and Cancer Referral Psychological intervention Developing country Vulnerable Populations Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Primary outcome Mexico city Neoplasms Health care medicine Humans Patient Navigation 030212 general & internal medicine General hospital Mexico Poverty Referral and Consultation Early Detection of Cancer Aged Aged 80 and over business.industry Cancer Care Facilities Middle Aged medicine.disease Oncology 030220 oncology & carcinogenesis Female Medical emergency business |
| Popis: | 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 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. |
| Databáze: | OpenAIRE |
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