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DOI: 10.1055/s-0043-1768696
Effect of a Patient Navigator Program to Address Barriers to Eye Care at an Academic Ophthalmology Practice
Funding This work was supported by the Henry L. Hillman Foundation, NIH CORE Grant P30 EY08098, the Eye and Ear Foundation of Pittsburgh, and from an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology at the University of Pittsburgh. Dr. Williams receives funding from Research to Prevent Blindness and a Mentoring for the Advancement of Physician Scientists (MAPS) award from the American Glaucoma Society.Abstract
Purpose The aim of this study was to determine whether a patient navigator program can address patient-reported barriers to eye care and to understand patient perceptions of a patient navigator program in ophthalmology.
Design This is a retrospective cohort study and cross-sectional patient survey.
Subjects and Methods A cohort of patients was recruited from a single academic ophthalmology department in the Mid-Atlantic region. Patients included in the study had received referral to the patient navigator program in the first quarter of 2022. Our patient navigator program provided patients with resources to address barriers to care such as transportation and financial assistance. Outcomes of the study included indications for referral, case resolution rate, and patient satisfaction.
Results In total, 130 referrals for 125 adult patients were included. The mean ± standard deviation age was 59 ± 17 years, 54 (44%) were male, 77 were white (62%), and 17 patients (14%) were uninsured. Common reasons for referral were transportation (52, 40%), insurance (34, 26%), and financial assistance (18, 14%). Among the 130 cases referred, 127 (98%) received an intervention from the patient navigator, who was able to resolve the referring issue in 90% of cases (117/130). Among 113 patients contacted for a follow-up telephone survey, 56 (50%) responded. Patients rated the program highly at a mean Likert rating of 4.87 out of 5. Moreover, 72% (31/43) of respondents stated their interactions with the patient navigator assisted them with taking care of their eyes.
Conclusions A patient navigator program can address barriers to eye care by connecting patients with community resources.
Keywords
barriers to care - access to care - patient navigator - outcomes research - social determinants of healthPublication History
Received: 17 October 2022
Accepted: 04 April 2023
Article published online:
14 May 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Williams AM, Weed JM, Commiskey PW, Kalra G, Waxman EL. Prevalence of diabetic retinopathy and self-reported barriers to eye care among patients with diabetes in the emergency department: the diabetic retinopathy screening in the emergency department (DRS-ED) study. BMC Ophthalmol 2022; 22 (01) 237
- 2 Chheda K, Wu R, Zaback T, Brinks MV. Barriers to eye care among participants of a mobile eye clinic. Cogent Med 2019; 6 (01) 1650693
- 3 Williams AM, Liu PJ, Muir KW, Waxman EL. Behavioral economics and diabetic eye exams. Prev Med 2018; 112: 76-87
- 4 Chou CF, Sherrod CE, Zhang X. et al. Barriers to eye care among people aged 40 years and older with diagnosed diabetes, 2006-2010. Diabetes Care 2014; 37 (01) 180-188
- 5 Gower EW, Silverman E, Cassard SD, Williams SK, Baldonado K, Friedman DS. Barriers to attending an eye examination after vision screening referral within a vulnerable population. J Health Care Poor Underserved 2013; 24 (03) 1042-1052
- 6 Williams AM, Sahel JA. Addressing social determinants of vision health. Ophthalmol Ther 2022; 11 (04) 1371-1382
- 7 Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer 2011; 117 (15, Suppl): 3539-3542
- 8 Di Palo KE, Patel K, Assafin M, Piña IL. Implementation of a patient navigator program to reduce 30-day heart failure readmission rate. Prog Cardiovasc Dis 2017; 60 (02) 259-266
- 9 Yee LM, Martinez NG, Nguyen AT, Hajjar N, Chen MJ, Simon MA. Using a patient navigator to improve postpartum care in an urban women's health clinic. Obstet Gynecol 2017; 129 (05) 925-933
- 10 Leiby BE, Hegarty SE, Zhan T. et al. A randomized trial to improve adherence to follow-up eye examinations among people with glaucoma. Prev Chronic Dis 2021; 18: E52
- 11 Fudemberg SJ, Amarasekera DC, Silverstein MH. et al. Overcoming barriers to eye care: patient response to a medical social worker in a glaucoma service. J Community Health 2016; 41 (04) 845-849
- 12 Hark LA, Madhava M, Radakrishnan A. et al. Impact of a social worker in a glaucoma eye care service: a prospective study. Health Soc Work 2019; 44 (01) 48-56
- 13 ACCESS. ACCESS. Accessed June 11, 2022 at: https://myaccessride.com/
- 14 Pennsylvania Department of Human Services. Medical assistance transportation program. Accessed at: http://matp.pa.gov/
- 15 Jean-Pierre P, Cheng Y, Wells KJ. et al; Patient Navigation Research Program. Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation. Cancer 2016; 122 (07) 1060-1067
- 16 Jandorf L, Braschi C, Ernstoff E. et al. Culturally targeted patient navigation for increasing African Americans' adherence to screening colonoscopy: a randomized clinical trial. Cancer Epidemiol Biomarkers Prev 2013; 22 (09) 1577-1587
- 17 National Academies of Sciences, Engineering, and Medicine. Making Eye Health a Population Health Imperative: Vision for Tomorrow. The National Academies Press; 2016:chapter 3