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Racial and ethnic differences in patient navigation: Results from the Patient Navigation Research Program
Author(s) -
Ko Naomi Y.,
Snyder Frederick R.,
Raich Peter C.,
Paskett Electra D.,
Dudley Donald J.,
Lee JiHyun,
Levine Paul H.,
Freund Karen M.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30109
Subject(s) - medicine , hazard ratio , confidence interval , ethnic group , cancer , health care , demography , gerontology , sociology , anthropology , economics , economic growth
BACKGROUND Patient navigation was developed to address barriers to timely care and reduce cancer disparities. The current study explored navigation and racial and ethnic differences in time to the diagnostic resolution of a cancer screening abnormality. METHODS The authors conducted an analysis of the multisite Patient Navigation Research Program. Participants with an abnormal cancer screening test were allocated to either navigation or control. The unadjusted median time to resolution was calculated for each racial and ethnic group by navigation and control. Multivariable Cox proportional hazards models were fit, adjusting for sex, age, cancer abnormality type, and health insurance and stratifying by center of care. RESULTS Among a sample of 7514 participants, 29% were non‐Hispanic white, 43% were Hispanic, and 28% were black. In the control group, black individuals were found to have a longer median time to diagnostic resolution (108 days) compared with non‐Hispanic white individuals (65 days) or Hispanic individuals (68 days) ( P <.0001). In the navigated groups, black individuals had a reduction in the median time to diagnostic resolution (97 days) ( P <.0001). In the multivariable models, among controls, black race was found to be associated with an increased delay to diagnostic resolution (hazard ratio, 0.77; 95% confidence interval, 0.69‐0.84) compared with non‐Hispanic white individuals, which was reduced in the navigated arm (hazard ratio, 0.85; 95% confidence interval, 0.77‐0.94). CONCLUSIONS Patient navigation appears to have the greatest impact among black patients, who had the greatest delays in care. Cancer 2016 . © 2016 American Cancer Society . Cancer 2016;122:2715–2722. © 2016 American Cancer Society.