Factors Associated with Patient Navigators' Time Spent on Reducing Barriers to Cancer Treatment
Factors Associated with Patient Navigators' Time Spent on Reducing Barriers to Cancer Treatment
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DOI：
10.1016/s0027-9684(15)31507-8
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发表时间：
2008-11-01
影响因子：
3.3
通讯作者：
Heron, Dwight E.
中科院分区：
文献类型：
--
作者：
Lin, Chyongchiou J.;Schwaderer, Karen A.;Heron, Dwight E.
患者导航计划的建立是为了减少癌症护理的障碍，特别是宾夕法尼亚州西部 3 家社区医院服务不足的人群。本研究旨在确定和比较招募最近诊断出患有任何类型癌症的患者所花费的时间、招募患者的特征、治疗障碍的类型以及患者导航员解决障碍所需的时间。在注册时，299 名注册者中有 253 名 (85%) 报告了障碍，最常见的问题是保险和自付费用 (31.5%) 以及交通 (24.6%)。导航员平均每位患者花费 2.5 小时。他们花在帮助未参保患者和帮助市中心患者上的时间明显多于参保患者。最多的时间花在财务问题（169分钟）、交通问题（74分钟）、临终问题（65分钟）、家属照顾安排（60分钟）、预约安排（34分钟）和日常生活活动协助（24分钟）上。总体而言，财务障碍是最常被报告且最耗时的。帮助癌症患者（尤其是贫困和服务不足的癌症患者）的患者导航员将需要大量时间来解决患者的经济和其他护理障碍。这些信息将有助于为未来的项目分配员工时间和案件量。
Patient navigator programs were established to mitigate barriers to cancer care, especially among underserved populations in 3 community hospitals in western Pennsylvania. This study was designed to determine and compare the time spent to enroll patients recently diagnosed with any type of cancer, the characteristics of enrolled patients, the types of barriers to treatment and the time it took patient navigators to address barriers. At enrollment, 253 (85%) of 299 enrollee's reported barriers, most frequently problems with insurance and out-of-pocket expenses (31.5%) and transportation (24.6%). Navigators spent an average of 2.5 hours per patient. They spent significantly more time helping uninsured than insured patients and helping patients at the inner-city site. The most time was spent on financial problems (169 minutes), transportation problems (74 minutes), end-of-life issues (65 minutes), arrangement for dependent care (60 minutes), scheduling of appointments (34 minutes) and assistance with activities of daily living (24 minutes). Overall, financial barriers were the most often reported and the most time consuming. Patient navigators assisting cancer patients, especially the poor and underserved, will require significant time to address patients' financial and other barriers to care. This information will be helpful in the allocation of staff time and case loads for future programs.