The economic impact of a patient navigator program to increase screening colonoscopy Journal Article
| Authors: | Elkin, E. B.; Shapiro, E.; Snow, J. G.; Zauber, A. G.; Krauskopf, M. S. |
| Article Title: | The economic impact of a patient navigator program to increase screening colonoscopy |
| Abstract: | BACKGROUND: Patient navigation can increase colorectal cancer screening rates. The net economic impact of a colonoscopy patient navigator program was evaluated in an urban public hospital setting. METHODS: Cost, cost-effectiveness, and cost-benefit analyses were performed of a colonoscopy patient navigation program at 3 urban public hospitals in the period from 2003 to 2007. Program effectiveness was assessed in a 2-group, pre- and post-program, nonrandomized evaluation, comparing program hospitals with comparison hospitals that served similar populations. Costs were assessed from the provider's perspective. Outcomes included colonoscopy volume, colonoscopy completion rate, program cost, incremental cost-effectiveness, and net monetary benefit. RESULTS: Patient navigation was associated with a 61% increase in average monthly colonoscopy volume at program hospitals, from 114 procedures to 184 procedures, compared with a 12% increase at comparison hospitals. Adjusted for other factors, the navigator program increased colonoscopy volume by 44 to 67 additional procedures per month. Average program cost varied from $50 to $300 per patient referred to a navigator. Incremental cost-effectiveness varied from $200 to $700 per additional colonoscopy. At 2 hospitals, net revenue associated with increased colonoscopy volume exceeded the program cost per additional colonoscopy, yielding a net financial benefit; at the third hospital, the program yielded a net cost. Variation between hospitals in the program's economic impact was primarily attributable to differences in personnel costs. CONCLUSIONS: Economic evaluation of this colonoscopy patient navigator program in an urban public hospital setting suggests that such programs can be a cost-effective use of limited resources and yield a net financial benefit for providers. © 2012 American Cancer Society. |
| Keywords: | adult; controlled study; aged; middle aged; major clinical study; cancer screening; colorectal neoplasms; cost effectiveness analysis; health care cost; health insurance; health program; reimbursement; patient care; colonoscopy; clinical effectiveness; early detection of cancer; cost-effectiveness analysis; cost-benefit analysis; public hospital; health care planning; patient referral; cost benefit analysis; patient navigation; patient navigators; urban area; patient navigator program |
| Journal Title: | Cancer |
| Volume: | 118 |
| Issue: | 23 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2012-12-01 |
| Start Page: | 5982 |
| End Page: | 5988 |
| Language: | English |
| DOI: | 10.1002/cncr.27595 |
| PROVIDER: | scopus |
| PUBMED: | 22605672 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 3 December 2012" - "CODEN: CANCA" - "Source: Scopus" |
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