title: Effects of Patient Navigation on Patient Satisfaction Outcomes.
abstract: Patient navigation (PN) may reduce cancer health disparities. Few studies have investigated the effects of PN on patient-reported satisfaction with care or assessed patients' satisfaction with navigators. The objectives of this study are to test the effects of PN on patient satisfaction with cancer care, assess patients' satisfaction with navigators, and examine the impact of barriers to care on satisfaction for persons with abnormal cancer-related screening tests or symptoms. Study participants included women and men with abnormal breast, cervical, or colorectal cancer screening tests and/or symptoms receiving care at 18 clinics. Navigated (n=416) and non-navigated (n=292) patients completed baseline and end-of-study measures. There was no significant difference between navigated and non-navigated patients in change in patient satisfaction with cancer care from baseline to exit. African-American (p<0.001), single (p=0.03), low income (p<0.01), and uninsured patients (p<0.001) were significantly less likely to report high patient satisfaction at baseline. A significant effect was found for change in satisfaction over time by employment status (p=0.04), with full-time employment showing the most improvement. The interaction between satisfaction with navigators and satisfaction with care over time was marginally significant (p=0.08). Baseline satisfaction was lower for patients who reported a barrier to care (p=0.02). Patients reporting other-focused barriers (p=0.03), including transportation (p=0.02), had significantly lower increases in satisfaction over time. Overall, results suggested that assessing barriers to cancer care and tailoring navigation to barrier type could enhance patients' experiences with health care. PN may have positive effects for healthcare organizations struggling to enhance quality of care.
authors.affiliation: Department of Family Medicine, College of Medicine, The Ohio State University, 2231 N. High St., Columbus, OH, 43201, USA.|Comprehensive Cancer Center, The Ohio State University, 1590 N. High St., Suite 525, Columbus, OH, 43201, USA.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Post
authors.affiliation: Department of Family Medicine, College of Medicine, The Ohio State University, 2231 N. High St., Columbus, OH, 43201, USA.|Comprehensive Cancer Center, The Ohio State University, 1590 N. High St., Suite 525, Columbus, OH, 43201, USA.
authors.forename: Ann Scheck
authors.initials: AS
authors.lastname: McAlearney
authors.affiliation: Center for Biostatistics, The Ohio State University, 2012 Kenny Rd., Columbus, OH, 43221, USA.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Young
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, 1590 N. High St., Suite 525, Columbus, OH, 43201, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Krok-Schoen
authors.affiliation: Biobehavioral Cancer Prevention and Control Training Program, University of Washington, PO Box 359455, Seattle, WA, 98195, USA.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Plascak
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, 1590 N. High St., Suite 525, Columbus, OH, 43201, USA. electra.paskett@osumc.edu.|Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, 395 W. 12th Ave., Columbus, OH, 43210, USA. electra.paskett@osumc.edu.|Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH, 43210, USA. electra.paskett@osumc.edu.
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D062526:Patient Navigation; D017060:Patient Satisfaction
keywords: Cancer screening; Disparities; Oncology; Patient navigation; Patient satisfaction; Quality improvement