The Impact of Patient Navigation on Healthcare Utilization in Pediatric and Adolescent Gynecology: A Retrospective Cohort Study.

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology Pub Date : 2026-04-27 DOI:10.1016/j.jpag.2026.04.009

Zoe T Appel, Sara G Vargo, Amanda V French, Sloane W Berger-Chen

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引用次数: 0

Abstract

Study objective: Pediatric and adolescent patients face barriers to accessing comprehensive reproductive healthcare. These barriers are intensified by limited infrastructure and confidentiality regulations that make scheduling, follow-up and communication more challenging. A patient navigator (PN) position was implemented within a newly established Pediatric and Adolescent Gynecology (PAG) clinic in a large urban medical center to improve access and support confidential care. This study evaluates the impact of the PN on PAG healthcare utilization and investigates the effects across racial and ethnic groups and insurance types.

Methods: A retrospective cohort study was conducted using electronic medical record data from Epic SlicerDicer®. Healthcare utilization metrics were compared for one year before (March 3, 2023 - March 3, 2024) and one year after (March 4, 2024 - March 4, 2025) implementation of the PN position.

Results: Following PN implementation, total appointments increased by 39% (P<0.001), completed follow-up visits increased by 65% (P<0.001) and missed appointment rate decreased by 44% (P<0.001). Patients who self-identified as Asian experienced a 66% decline in missed appointment rate (P=0.031), those who selected "Other" had a 49% decrease (P=0.003), and the "Unknown/Declined" racial group saw a 57% decrease (P=0.041). Additionally, patients with public insurance saw a 49% (P<0.001) decrease.

Conclusion: Establishing a PN in a PAG clinic improves utilization of care, continuity and appointment adherence. We observed significant reductions in missed appointment rate among several racial and ethnic groups and in the underrepresented group of patients with public insurance.

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儿童和青少年妇科患者导航对医疗保健利用的影响：一项回顾性队列研究。

研究目的：儿科和青少年患者在获得全面生殖保健方面面临障碍。有限的基础设施和保密规定加剧了这些障碍，使日程安排、后续行动和沟通更具挑战性。在一个大型城市医疗中心新建立的儿科和青少年妇科（PAG）诊所内实施了患者导航员（PN）职位，以改善获取和支持保密护理的机会。本研究评估了PN对PAG医疗保健利用的影响，并调查了种族和民族群体和保险类型的影响。方法：使用Epic SlicerDicer®的电子病历数据进行回顾性队列研究。比较了实施PN职位之前（2023年3月3日至2024年3月3日）和之后一年（2024年3月4日至2025年3月4日）的医疗保健利用率指标。结果：实施PN后，总预约增加了39%(结论：在PAG诊所建立PN提高了护理的利用率、连续性和预约依从性。我们观察到，在几个种族和民族群体中，以及在未被充分代表的公共保险患者群体中，未预约率显著降低。

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

Journal of pediatric and adolescent gynecology 医学-妇产科学

CiteScore

3.90

自引率

11.10%

发文量

251

审稿时长

57 days

期刊介绍： Journal of Pediatric and Adolescent Gynecology includes all aspects of clinical and basic science research in pediatric and adolescent gynecology. The Journal draws on expertise from a variety of disciplines including pediatrics, obstetrics and gynecology, reproduction and gynecology, reproductive and pediatric endocrinology, genetics, and molecular biology. The Journal of Pediatric and Adolescent Gynecology features original studies, review articles, book and literature reviews, letters to the editor, and communications in brief. It is an essential resource for the libraries of OB/GYN specialists, as well as pediatricians and primary care physicians.