Effectiveness and cost of implementing a patient navigation program to increase colorectal cancer screening in a large federally qualified health center

IF 5.1 2区医学 Q1 ONCOLOGY

Cancer Pub Date : 2025-08-09 DOI:10.1002/cncr.70031

Florence K. L. Tangka PhD, Esmeralda Ruiz MPH, Raylene Ibarra BA, Sharon M. Hudson PhD, Valerie Richmond-Reese BA, Sonja Hoover MPP, Mark Krudy BA, Sujha Subramanian PhD

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Abstract

Introduction

The purpose of this study was to evaluate the effectiveness and cost of a patient navigation (PN) program in a large federally qualified health center (FQHC).

Methods

The PN program implemented at AltaMed was evaluated; it is an FQHC that participated in the Centers for Disease Control and Prevention’s Colorectal Cancer Control Program. A tailored data collection tool was developed to collect time and resources spent on program activities, salaries of staff, nonlabor resources, and process and outcome measures for 2021–2023. Sociodemographic characteristics and screening uptake for 2020–2023 was collected. Screening uptake and percentage of stool-based tests returned by year and intervention type and compared process measures was calculated, as was the cost of strategies used to increase uptake of stool-based colorectal cancer screening tests.

Results

The percentage of fecal immunochemical tests (FIT) returned among those receiving the PN program ranged from 36.6% in 2021 to 51.0% in 2023. The total annual cost for PN, mailings of FITs, and cost of the FIT kits ranged from $328,000 to $388,000 across the 3 years. The FQHC cost per person completing FITs decreased from $32 in 2021 to $25 in 2023. The total cost (FQHC and payer reimbursement) was calculated at $54 in 2021, $44 in 2022, and $47 in 2023 for each person completing FIT. The total cost was $512 in 2022 and $513 in 2023 per person completing Cologuard.

Conclusion

The PN program, which used reminder texts and calls, alongside mass mailings of stool kits, increased kit returns over the implementation period.

Abstract Image

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在大型联邦合格医疗中心实施患者导航计划以增加结直肠癌筛查的有效性和成本。

简介：本研究的目的是评估大型联邦合格医疗中心（FQHC）患者导航（PN）计划的有效性和成本。方法：对AltaMed实施的PN方案进行评价；它是一个FQHC参与了疾病控制和预防中心的结直肠癌控制项目。开发了量身定制的数据收集工具，用于收集2021-2023年在项目活动、员工工资、非劳动力资源以及过程和结果度量方面花费的时间和资源。收集2020-2023年的社会人口学特征和筛查情况。计算了按年份、干预类型和比较过程措施返回的基于粪便的筛查接受率和百分比，以及用于增加基于粪便的结肠直肠癌筛查测试接受率的策略的成本。结果：在接受PN计划的患者中，粪便免疫化学测试（FIT）返回的百分比从2021年的36.6%到2023年的51.0%不等。三年间，PN、FIT邮寄和FIT套件的年总成本从328,000美元到388,000美元不等。完成fit的人均FQHC成本从2021年的32美元降至2023年的25美元。每个完成FIT的人的总成本（FQHC和付款人报销）在2021年为54美元，2022年为44美元，2023年为47美元。2022年完成Cologuard的人均总成本为512美元，2023年为513美元。结论：PN项目采用短信和电话提醒以及大量邮寄粪便包的方式，在实施期间提高了粪便包的回收率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research