Patient and Provider Perceptions of a Patient Navigation Program to Improve Postpartum Care Among Publicly Insured Women

2019 ◽  
Author(s):  
Fengling Hu ◽  
Angelina Strohbach ◽  
Noelle G. Martinez ◽  
Melissa A. Simon ◽  
Lynn M. Yee
Keyword(s):  
Patient Satisfaction ◽  
Low Income ◽  
Patient Navigation ◽  
Clinical Care ◽  
Comparative Method ◽  
Interpersonal Relationship ◽  
Program Satisfaction ◽  
Provider Perceptions ◽  
Navigation Program ◽  
Publicly Insured

Abstract Objective This study was aimed to assess patient and provider perceptions of a postpartum patient navigation program. Study Design This was a mixed-method assessment of a postpartum patient navigation program. Navigating New Motherhood (NNM) participants completed a follow-up survey including the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I) scale and an open-ended question. PSN-I scores were analyzed descriptively. Eighteen provider stakeholders underwent in-depth interviews to gauge program satisfaction, perceived outcomes, and ideas for improvement. Qualitative data were analyzed by the constant comparative method. Results In this population of low-income, minority women, participants (n = 166) were highly satisfied with NNM. The median PSN-I score was 45 out of 45 (interquartile range [IQR]: 43–45), where a higher score corresponds to higher satisfaction. Patient feedback was also highly positive, though a small number desired more navigator support. Provider stakeholders offered consistently positive program feedback, expressing satisfaction with NNM execution and outcomes. Provider stakeholders noted that navigators avoided inhibiting clinic workflow and eased clinic administrative burden. They perceived NNM improved multiple clinical and satisfaction outcomes. All provider stakeholders believed that NNM should be sustained long-term; suggestions for improvement were offered. Conclusion A postpartum patient navigation program can perceivably improve patient satisfaction, clinical care, and clinic workflow without burden to clinic providers.

scholarly journals 320 Obstetric clinician needs assessment for a postpartum patient navigation program for low-income patients

2021 ◽  
Vol 224 (2) ◽  
pp. S210
Author(s):  
Rachel S. Ruderman ◽  
Emma C. Dahl ◽  
Brittney R. Williams ◽  
Joe M. Feinglass ◽  
Michelle Kominiarek ◽  
...  
Keyword(s):  
Needs Assessment ◽  
Low Income ◽  
Patient Navigation ◽  
Navigation Program

Obstetric Provider Perspectives on Postpartum Patient Navigation for Low-Income Patients

2021 ◽  
pp. 109019812110431
Author(s):  
Rachel S. Ruderman ◽  
Emma C. Dahl ◽  
Brittney R. Williams ◽  
Joe M. Feinglass ◽  
Michelle A. Kominiarek ◽  
...  
Keyword(s):  
Focus Groups ◽  
Low Income ◽  
Patient Navigation ◽  
Medical Center ◽  
Comparative Method ◽  
Academic Medical Center ◽  
Obstetric Care ◽  
Successful Implementation ◽  
Semistructured Interview ◽  
Provider Perspectives

Background Patient navigation programs have shown promise for improving health but are not widely used in obstetric care. Our objective was to understand obstetric provider perspectives on how to implement patient navigation to optimize care during the postpartum period for low-income patients. Method Focus groups were conducted with obstetric physicians, nurses, and social workers who care for low-income pregnant and postpartum patients in an academic medical center. Semistructured interview guides were developed to elicit conversations about the potential value of patient navigators, recommendations for navigator training, and how navigators could be most effective in improving postpartum care. Analysis of themes was based on the constant comparative method. Results Twenty-six obstetric providers (six focus groups) discussed elements for a successful obstetric navigation program. Successful implementation themes included selecting navigators with appropriate interpersonal attributes, arranging navigator training, and identifying the most valuable services navigators could render. Desirable navigator attributes included persistence in patient advocacy, consistency, relatability, and a supportive manner. Training recommendations included learning the health care system, identifying where to obtain health system and community resources, and learning how be effective health educators. Suggested services were broad, ranging from traditional care coordination to specific educational and resource-driven tasks. Conclusions Obstetric providers perceive patient navigation to be a potentially beneficial resource to support low-income patients and offered recommendations for navigation implementation. These included suggestions for patient-centered navigators, with specific training and services focused on promoting care continuity and coordination.

scholarly journals Differences in healthcare expenditures for inflammatory bowel disease by insurance status, income, and clinical care setting

2014 ◽  
Author(s):  
Michelle Park ◽  
Jay Bhattacharya ◽  
KT Park
Keyword(s):  
Inflammatory Bowel Disease ◽  
Low Income ◽  
Bowel Disease ◽  
Clinical Care ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Status ◽  
Inflammatory Bowel ◽  
Publicly Insured ◽  
Insured Patients

Background: Socioeconomic factors and insurance status have not been correlated with differential use of healthcare services in inflammatory bowel disease (IBD). Aim: To describe IBD-related expenditures based on insurance and household income with the use of inpatient, outpatient, emergency, and office-based services, and prescribed medications in the United States (US). Methods: We evaluated the Medical Expenditure Panel Survey from 1996 to 2011 of individuals with Crohn’s disease (CD) or ulcerative colitis (UC). Nationally weighted means, proportions, and multivariate regression models examined the relationships between income and insurance status with expenditures. Results: Annual per capita mean expenditures for CD, UC, and all IBD were $10,364 (N=238), $7,827 (N=95), and $9,528, respectively, significantly higher than non-IBD ($4,314, N=276,372, p<0.05). Publicly insured patients incurred the highest costs ($18,067), over privately insured ($8,014, p<0.05) or uninsured patients ($5,129, p<0.05). Among all IBD patients, inpatient care composed the highest proportion of costs ($3,392, p<0.05). Inpatient costs were disproportionately higher for publicly insured patients. Public insurance had higher odds of total costs than private (OR 2.13, CI 1.08-4.19) or no insurance (OR 4.94, CI 1.26-19.47), with increased odds for inpatient and emergency care. Private insurance had higher costs associated with outpatient care, office-based care, and prescribed medicines. Low-income patients had lower costs associated with outpatient (OR 0.38, CI 0.15-0.95) and office-based care (OR 0.21, CI 0.07-0.62). Conclusions: In the US, high inpatient utilization among publicly insured patients is a previously unrecognized driver of high IBD costs. Bridging this health services gap between SES strata for acute care services may curtail direct IBD-related costs.

scholarly journals Differences in healthcare expenditures for inflammatory bowel disease by insurance status, income, and clinical care setting

2014 ◽  
Author(s):  
Michelle Park ◽  
Jay Bhattacharya ◽  
KT Park
Keyword(s):  
Inflammatory Bowel Disease ◽  
Low Income ◽  
Bowel Disease ◽  
Clinical Care ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Status ◽  
Inflammatory Bowel ◽  
Publicly Insured ◽  
Insured Patients

Background: Socioeconomic factors and insurance status have not been correlated with differential use of healthcare services in inflammatory bowel disease (IBD). Aim: To describe IBD-related expenditures based on insurance and household income with the use of inpatient, outpatient, emergency, and office-based services, and prescribed medications in the United States (US). Methods: We evaluated the Medical Expenditure Panel Survey from 1996 to 2011 of individuals with Crohn’s disease (CD) or ulcerative colitis (UC). Nationally weighted means, proportions, and multivariate regression models examined the relationships between income and insurance status with expenditures. Results: Annual per capita mean expenditures for CD, UC, and all IBD were $10,364 (N=238), $7,827 (N=95), and $9,528, respectively, significantly higher than non-IBD ($4,314, N=276,372, p<0.05). Publicly insured patients incurred the highest costs ($18,067), over privately insured ($8,014, p<0.05) or uninsured patients ($5,129, p<0.05). Among all IBD patients, inpatient care composed the highest proportion of costs ($3,392, p<0.05). Inpatient costs were disproportionately higher for publicly insured patients. Public insurance had higher odds of total costs than private (OR 2.13, CI 1.08-4.19) or no insurance (OR 4.94, CI 1.26-19.47), with increased odds for inpatient and emergency care. Private insurance had higher costs associated with outpatient care, office-based care, and prescribed medicines. Low-income patients had lower costs associated with outpatient (OR 0.38, CI 0.15-0.95) and office-based care (OR 0.21, CI 0.07-0.62). Conclusions: In the US, high inpatient utilization among publicly insured patients is a previously unrecognized driver of high IBD costs. Bridging this health services gap between SES strata for acute care services may curtail direct IBD-related costs.

scholarly journals Cross-cultural validation of a Patient Satisfaction with Interpersonal Relationship with Navigator measure: a multi-site patient navigation research study

2011 ◽  
Vol 21 (12) ◽  
pp. 1309-1315 ◽  
Author(s):  
Pascal Jean-Pierre ◽  
Kevin Fiscella ◽  
Paul C. Winters ◽  
Electra Paskett ◽  
Kristen Wells ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Patient Navigation ◽  
Research Study ◽  
Interpersonal Relationship ◽  
Cross Cultural ◽  
Cultural Validation

scholarly journals Scoping review protocol: bladder cancer in Nigeria: what are the gaps in clinical care and research?

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041894
Author(s):  
Joyce Kibaru ◽  
Pinky Kotecha ◽  
Abdulkarim Muhammad Iya ◽  
Beth Russell ◽  
Muzzammil Abdullahi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Scoping Review ◽  
Low Income ◽  
Clinical Care ◽  
Grey Literature ◽  
Case Series ◽  
Cochrane Library ◽  
Future Research ◽  
Scoping Reviews ◽  
Local Risk

IntroductionBladder cancer (BC) is the 10th common cancer worldwide and ranks seventh in Nigeria. This scoping review aims to identify the gaps in clinical care and research of BC in Nigeria as part of the development of a larger national research programme aiming to improve outcomes and care of BC.Methods and analysisThis review will be conducted according to Arksey and O’Malley scoping review methodology framework. The following electronic databases will be searched: Medline (using the PubMed interface), Ovid Gateway (Embase and Ovid), Cochrane library and Open Grey literature. Two independent reviewers will screen titles and abstracts and subsequently screen full-text studies for inclusion, any lack of consensus will be discussed with a third reviewer. Any study providing insight into the epidemiology or treatment pathway of BC (RCTs, observations, case series, policy paper) will be included. A data chart will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A consultation process will be carried out with a multidisciplinary team of Nigerian healthcare professionals, patients and scientists.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. By highlighting the key gaps in the literature, this review can provide direction for future research and clinical guidelines in Nigeria (and other low-income and middle-income countries), where BC is more prevalent due to local risk factors and healthcare settings.

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