| Effect of a patient navigator program on the volume and quality of colonoscopy. | |
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MedLine Citation:
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PMID: 21030874 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND GOALS: To increase colorectal cancer screening among urban minorities, New York Presbyterian Hospital/Columbia University, with support from the New York City Department of Health and the Citywide Colon Cancer Control Coalition (C5), instituted a patient navigation and direct endoscopic referral system. We assessed the effect of this program on the volume of colonoscopy in this institution, which caters to a socioeconomically diverse patient population. STUDY: We compared colonoscopy volume during the first year of the navigator program with the volume during the year before this program. We stratified on Medicaid status to assess the secular trend of screening rates. To assess quality during this period, we measured cecal intubation rates, preparation quality, and adenoma detection rates. RESULTS: Of the 749 patients assessed by the patient navigators, 678 (91%) underwent colonoscopy. Colonoscopy volume among the Medicaid outpatients increased by 56% (957 to 1489). Adenoma detection was 27% and the cecal intubation rate was 97%. Comparing navigated patients with the nonnavigated Medicaid outpatients, preparation quality was superior (34% vs. 40% suboptimal, P=0.0282), although preparation quality remained inferior to that of private patients (20% suboptimal, P<0.0001). CONCLUSIONS: Volume of the colonoscopy increased, coinciding with the onset of the patient navigation program. This increase was nearly entirely owing to a rise in the colonoscopies among Medicaid outpatients, the principal focus of the navigator program. This increase in quantity was accomplished while maintaining an overall high level of quality as measured by cecal intubation rates and adenoma detection, although preparation quality requires further efforts at improvement. |
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Authors:
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Benjamin Lebwohl; Alfred I Neugut; Eliezer Stavsky; Sonia Villegas; Corinne Meli; Orlando Rodriguez; Carmen Franco; Marian S Krauskopf; Richard Rosenberg |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 45 ISSN: 1539-2031 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2011 May-Jun |
Date Detail:
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Created Date: 2011-04-11 Completed Date: 2011-08-15 Revised Date: 2012-05-02 |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: e47-53 Citation Subset: IM |
Affiliation:
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Department of Medicine, Division of Digestive and Liver Diseases, Mailman School of Public Health, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY 10032, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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diagnosis,
prevention & control Aged Aged, 80 and over Colonoscopy / statistics & numerical data* Colorectal Neoplasms / diagnosis*, prevention & control Community Health Workers Early Detection of Cancer Female Hispanic Americans Hospitals, Municipal Humans Male Mass Screening / utilization Medicaid Middle Aged New York City Program Evaluation* Quality of Health Care* Referral and Consultation* United States |
| Grant Support | |
ID/Acronym/Agency:
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T32 CA009529-22/CA/NCI NIH HHS; T32 CA095929/CA/NCI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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