Dedicated patient navigator cost-effective, improved FIT return rates by nearly 38%
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CHICAGO — Adding a dedicated patient navigator improved fecal immunochemical testing completion and return rates and resulted in significant savings to the health care system, according to data presented at Digestive Disease Week.
“A patient navigator is someone whose dedicated role is to help guide patients through the health care system, removing barriers to care wherever possible,” Hannah Winthrop Fiske, MD, an internal medicine resident at the Warren Alpert Medical School of Brown University, told Healio. “Health care disparities are dramatically apparent when examining CRC screening rates.”
Fiske continued: “We implemented a dedicated culturally competent, language congruent patient navigator to improve the yield of screening FIT, in the hopes of addressing some of the disparities in screening in our population.”
Fiske and colleagues analyzed FIT testing results for 3,544 individuals aged 45 years or older at a single internal medicine clinic from January 2017 through December 2021. Researchers introduced a patient navigator in January 2021 and compared the average cost of colorectal cancer screening per patient before and after the intervention, as well as FIT drop off and rates of colonoscopy. The post-intervention group included 30.6% of the study population.
Results showed a dedicated patient navigator improved FIT kit drop off rates by 37.7% (HR = 1.38; 95% CI, 1.25-1.51). Researchers noted that individuals in the pre-intervention group had a nearly fourfold increased chance of undergoing colonoscopy (HR = 3.6; 95% CI, 2.28-5.73) as well as a higher average number of exams per patient (1.5 vs. 1.06).
Further, the addition of a patient navigator — which cost about $4.52 per patient, according to Fiske — decreased the total cost of CRC screening by $874.18 ($72 vs. $946.1) per patient in the post-intervention group.
“The implementation of our patient navigator program has significantly improved our FIT kit completion rates,” Fiske said. “Our overall return rates increased from 55% to 73%.”
She continued, “Despite the upfront cost of hiring a patient navigator, it is a cost-effective intervention and the savings to the health care system are significant. Our ultimate goal is to urge health care systems, insurance companies and payers, and state health departments to heavily consider providing funding for the role of patient navigator to aid in screening programs.”
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Fiske HW, et al. Abstract 410: A cost analysis review of the addition of a patient navigator and fecal immunochemical testing on colorectal cancer screening. Presented at: Digestive Disease Week; May 6-9, 2023; Chicago (hybrid).
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