scholarly journals Comparing enrolees with non-enrolees of cancer-patient navigation at end of life

2018 ◽  
Vol 25 (3) ◽  
pp. 184 ◽  
Author(s):  
G. Park ◽  
G.M. Johnston ◽  
R. Urquhart ◽  
G. Walsh ◽  
M. McCallum
Keyword(s):  
Cancer Patient ◽  
End Of Life ◽  
Patient Navigation ◽  
Population Based ◽  
Population Based Study ◽  
Patient Navigators ◽  
Disease Trajectory ◽  
Study Population ◽  
Ongoing Surveillance ◽  
Cancer Patient Navigation

Background Cancer-patient navigators who are oncology nurses support and connect patients to resources throughout the cancer care trajectory, including end of life. Although qualitative and cohort studies of navigated patients have been reported, no population-based studies were found. The present population-based study compared demographic, disease, and outcome characteristics for decedents who had been diagnosed with cancer by whether they did or did not see a navigator.Methods This retrospective study used patient-based administrative data in Nova Scotia (cancer registry, death certificates, navigation visits) to generate descriptive statistics. The study population included all adults diagnosed with cancer who died during 2011–2014 of a cancer or non-cancer cause of death.Results Of the 7694 study decedents, 74.9% had died of cancer. Of those individuals, 40% had seen a navigator at some point in their disease trajectory. The comparable percentage for those who did not die of cancer was 11.9%. Decedents at the oldest ages had the lowest navigation rates. Navigation rates, time from diagnosis to death, and time from last navigation visit to death varied by disease site.Conclusions This population-based study of cancer-patient navigation enrolees compared with non-enrolees is the first of its kind. Most findings were consistent with expectations. However, we do not know whether the rates of navigation are consistent with the navigation needs of the population diagnosed with cancer. Because more people are living longer with cancer and because the population is aging, ongoing surveillance of who requires and who is using navigation services is warranted.

A User-Centered Need Analysis of Cancer Patient Navigation — An Intersection of Collaborative Work and Collaborative Health IT

2021 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Wayne W. Zachary ◽  
Courtney C. Rogers ◽  
Jennifer McEachin ◽  
Donna M. Wilson ◽  
Wendy F. Cohn ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Patient Navigation ◽  
Collaborative Work ◽  
Qualitative Interviews ◽  
Patient Navigator ◽  
Patient Navigators ◽  
Need Analysis ◽  
Navigation Support ◽  
Cancer Patient Navigation ◽  
To Receive

Cancer care is becoming more complex each year, making the patient’s path to, and through the care continuum confusing and daunting. Patient-navigation programs for cancer patients have grown in recent years, but their navigation support is fragmented in many ways and often incomplete, lessening their effectiveness. Digital tools to support the cancer patient navigator can make them more effective and allow more patients to receive navigation support. A multifaceted analysis of the needs for such tools is presented. The analysis methods include literature review, domain analysis, and qualitative interviews with a sample of ten cancer patient navigators.

scholarly journals Describing the characteristics and healthcare use of high-cost acute care users at the end of life: a pan-Canadian population-based study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Danial Qureshi ◽  
Sarina Isenberg ◽  
Peter Tanuseputro ◽  
Rahim Moineddin ◽  
Kieran Quinn ◽  
...  
Keyword(s):  
End Of Life ◽  
Acute Care ◽  
Significant Proportion ◽  
Population Based ◽  
Fiscal Year ◽  
Healthcare Use ◽  
Population Based Study ◽  
Canadian Population ◽  
Alternate Level Of Care ◽  
Care Costs

Abstract Background A minority of individuals use a large portion of health system resources, incurring considerable costs, especially in acute-care hospitals where a significant proportion of deaths occur. We sought to describe and contrast the characteristics, acute-care use and cost in the last year of life among high users and non-high users who died in hospitals across Canada. Methods We conducted a population-based retrospective-cohort study of Canadian adults aged ≥18 who died in hospitals across Canada between fiscal years 2011/12–2014/15. High users were defined as patients within the top 10% of highest cumulative acute-care costs in each fiscal year. Patients were categorized as: persistent high users (high-cost in death year and year prior), non-persistent high users (high-cost in death year only) and non-high users (never high-cost). Discharge abstracts were used to measure characteristics and acute-care use, including number of hospitalizations, admissions to intensive-care-unit (ICU), and alternate-level-of-care (ALC). Results We identified 191,310 decedents, among which 6% were persistent high users, 41% were non-persistent high users, and 46% were non-high users. A larger proportion of high users were male, younger, and had multimorbidity than non-high users. In the last year of life, persistent high users had multiple hospitalizations more often than other groups. Twenty-eight percent of persistent high users had ≥2 ICU admissions, compared to 8% of non-persistent high users and only 1% of non-high users. Eleven percent of persistent high users had ≥2 ALC admissions, compared to only 2% of non-persistent high users and < 1% of non-high users. High users received an in-hospital intervention more often than non-high users (36% vs. 19%). Despite representing only 47% of the cohort, persistent and non-persistent high users accounted for 83% of acute-care costs. Conclusions High users – persistent and non-persistent – are medically complex and use a disproportionate amount of acute-care resources at the end of life. A greater understanding of the characteristics and circumstances that lead to persistently high use of inpatient services may help inform strategies to prevent hospitalizations and off-set current healthcare costs while improving patient outcomes.

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