Improving Patient Outcomes Through System Navigation

通过系统导航改善患者治疗效果

基本信息

批准号：
7278731
负责人：
PETER Christian RAICH
金额：
$ 60.64万
依托单位：
DENVER HEALTH AND HOSPITAL AUTHORITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-15 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7278731
关键词：
Address Adherence Appointment Area Breast Cancer Control Research Caring Colorectal Communities Consultations Control Groups Counseling Diagnosis Diagnostic Diagnostic tests Distress Education Goals Health Health Personnel Healthcare Healthcare Systems Individual Institution Insurance Intervention Investments Link Malignant Neoplasms Malignant neoplasm of prostate Medical Medical Care Team Medical center Minority Navigation System Numbers Outcome Pathologic Patient Outcomes Assessments Patients Persons Population Primary Health Care Program Evaluation Randomized Controlled Clinical Trials Range Recommendation Research Resources Sampling Screening for cancer Screening procedure Self Efficacy Services Site Source Standards of Weights and Measures System Telephone Testing Time Uninsured Visit Voice cancer care cancer diagnosis cancer therapy cost effectiveness design experience follow-up health disparity improved innovation metropolitan patient oriented programs psychosocial response safety net satisfaction socioeconomics

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this application is to address a national priority in cancer control research by developing and conducting a highly innovative patient navigation program from the point of abnormal screening test to treatment for breast, colorectal and prostate cancers. The major venue for this program of research will be the Denver Health Medical Center (DH), which is the single largest "safety net" health care system linked to a major metropolitan area in the Rocky Mountain Region. DH serves a large number of minority (75%) and underserved patients (almost half without insurance). Unique features of this research are: (1) testing for efficacy and cost-effectiveness a comprehensive patient navigator program that will extend an existing and exemplary community lay health worker demonstration project at DH (Community Voices); (2) combining this resource with a well-established telephone counseling service to specifically address patient-centered psychosocial barriers; and (3) integrating these components into a comprehensive patient navigator program within the context of the healthcare provider institution. The following specific aims will guide the evaluation of this program: (1) to reduce the time between an abnormal screening test for breast, colorectal and prostate cancers to a positive or negative pathologic diagnosis; (2) to reduce the time from a positive pathologic diagnosis of breast, colorectal or prostate cancers to the start of therapy; (3) to increase the proportion of these patients adhering to recommendations for care, including completion of additional diagnostic tests, consultation appointments, and completion of treatment; (4) to improve patient reported outcomes of medical self-efficacy, satisfaction with care and distress related to cancer diagnosis in a sample of individuals with a negative pathologic diagnosis and among all individuals with a positive pathologic diagnosis; and (5) to examine the cost-effectiveness and return on investment of patient navigation. Ultimately we will demonstrate the efficacy and assess the financial impact associated with the implementation of a comprehensive navigation program designed to address disparities in cancer-related outcomes among the poor and underserved

描述（由申请人提供）：该应用程序的总体目标是通过从异常筛查测试到乳腺癌，结直肠癌和前列腺癌的治疗方法来开发和开发高度创新的患者导航计划，以解决癌症控制研究的国家优先事项。该研究计划的主要场所将是丹佛健康医疗中心（DH），该中心是与落基山地区一个主要的大都市地区相关的最大的“安全网”医疗系统。 DH为大量少数族裔（75％）和服务不足的患者服务（几乎没有保险）。这项研究的独特特征是：（1）测试功效和成本效益的全面患者导航器计划，该计划将扩展DH（社区声音）的现有和典范的社区外行工作人员示范项目；（2）将此资源与已建立的电话咨询服务相结合，以专门针对以患者为中心的社会心理障碍；（3）在医疗保健提供商机构的背景下将这些组件集成到全面的患者导航器计划中。以下具体目的将指导对该程序的评估：（1）减少乳腺癌，结直肠癌和前列腺癌异常筛查测试之间的时间，以进行阳性或阴性的病理诊断；（2）从乳房，结直肠癌或前列腺癌的阳性病理学诊断到开始治疗的时间；（3）增加遵守护理建议的患者的比例，包括完成额外的诊断测试，咨询任命和完成治疗；（4）为了改善患者报告的医学自我效能感，对患有阴性病理诊断的个体的样本以及所有具有阳性病理学诊断的个体的患者的护理和困扰的满意度；（5）检查患者导航的成本效益和投资回报率。最终，我们将证明疗效并评估与实施全面导航计划相关的财务影响