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Do Better-Rated Navigators Improve Patient Satisfaction with Cancer-Related Care?
Authors:Pascal Jean-Pierre  Paul C Winters  Jack A Clark  Victoria Warren-Mears  Kristen J Wells  Douglas M Post  Nancy LaVerda  Mary Ann Van Duyn  Kevin Fiscella
Institution:1. Harper Cancer Research Institute, Notre Dame, IN, USA
10. Department of Psychology, University of Notre Dame, 109 Haggar Hall, Notre Dame, IN, 46556, USA
2. Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
3. Center for Health Quality, Outcomes, and Economic Research—VA HSR&D, Boston University School of Public Health, Boston, MA, USA
4. Northwest Portland Area Indian Health Board, Tribal Epidemiology Center, Portland, OR, USA
5. Center for Evidence-based Medicine and Health Outcomes Research, University of South Florida College of Medicine, Tampa, FL, USA
6. Department of Family Medicine, Ohio State Wexner Medical Center, Columbus, OH, USA
7. George Washington University (GWU) Cancer Institute, GWU Medical Center, Washington, DC, USA
8. Center to Reduce Cancer Health Disparities, National Cancer Institute, Rockville, MD, USA
Abstract:Patient navigation has emerged as a promising strategy for addressing racial-ethnic and socioeconomic disparities in cancer-related care. However, little is known about the impact of patients’ perception of the quality of navigation on patient outcomes. We examined the impact of better-rated navigators on patients’ satisfaction with cancer-related care. The sample included 1,593 adults (85.8 % with abnormal cancer screening and 14.2 % with confirmed cancer diagnosis) who received patient navigation. We defined better-rated navigators as those scoring above the first quartile of mean scores on the Patient Satisfaction with Interpersonal Relationship with Navigator scale. We defined patient satisfaction based on scores above or below the median of the Patient Satisfaction with Cancer-Related Care (PSCC) scale. We controlled for patient and site characteristics using backward selection logistic regression analyses. Among patients with abnormal screening, having a better-rated navigator was associated with higher score on the PSCC (p?<?0.05). After controlling for other bivariate predictors of satisfaction (e.g., age, race, income, and household size), navigation by better-rated navigators was associated with a greater likelihood of having higher patient satisfaction odds ratio (OR), 1.38; 95 % confidence interval (CI), 1.05–1.82]. Similar findings between better-rated navigators and score on the PSCC were found for participants with diagnosed cancer (OR, 3.06; 95 % CI, 1.56–6.0). Patients navigated by better-rated navigators reported higher satisfaction with their cancer-related care.
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