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A dedicated patient navigator improved FIT return rates by nearly 38%
A patient navigator helps patients through the healthcare system by removing barriers to care wherever possible. A recent study presented at Digestive Disease Week in Chicago, IL found that adding a dedicated patient navigator improved fecal immunochemical testing completion and return rates and resulted in significant cost reduction.
The fecal immunochemical test (FIT) is a population-based screening test for colorectal cancer. By examining stool samples for tiny amounts of blood, it is used as a way to identify people who may have colorectal cancer (CRC). When someone receives a positive FIT result indicating the presence of blood in the stool, it is always followed up with a colonoscopy to determine the exact cause of bleeding. The FIT is recommended in Canada for all individuals 50 -74 years of age at average risk for CRC. Currently, CRC screening rates in Canada remain below the national target of 60% of eligible individuals. As highlighted by the study researchers, disparities or differences in access across different population groups such as marginalized and become very obvious when examining CRC screening rates.
To address the healthcare disparities that exist in CRC screening, the researchers implemented a culturally competent patient navigator dedicated to supporting individuals to improve the yield of FIT screening.
The researchers analyzed FIT results from 3,544 individuals aged 45 years or older at an internal medicine clinic from January 2017 to December 2021.
In January 2021, a patient navigator was introduced and the researchers compared the average cost of CRC screening per patient before and after the intervention, as well as FIT return (how many people returned completed tests) rates and colonoscopy rates.
Having a dedicated patient navigator was shown to improve FIT return rates by 37.7%. Prior to the installment of the patient navigator at the clinic, individuals had a nearly fourfold increased chance of undergoing a colonoscopy, as well as a higher average number of exams per patient.
The addition of a patient navigator added a cost of about $4.52 USD per patient according to the researchers but resulted in a reduction of the total cost of screening by $874.18 ($72 vs. $946.1) per patient in the post-intervention group. The addition of a patient navigator was found to significantly improve FIT kit complete rates, and overall return rates increased from 55% to 73%.
Take home message
Despite the cost of hiring a patient navigator, it is a cost-effective intervention and the savings that result from it are significant. The ultimate goal, the researchers note, is to urge healthcare systems, insurance companies and payers to heavily consider funding for the role of patient navigator to assist in screening programs.