Evaluating the cost-effectiveness of cancer patient navigation programs

Conceptual and practical issues

Scott Ramsey*, Elizabeth Whitley, Victoria Warren Mears, June M McKoy, Rachel M. Everhart, Robert J. Caswell, Kevin Fiscella, Thelma C. Hurd, Tracy Battaglia, Jeanne Mandelblatt

*Corresponding author for this work

Research output: Contribution to journalReview article

36 Citations (Scopus)

Abstract

Patient navigators-individuals who assist patients through the healthcare system to improve access to and understanding of their health and healthcare - are increasingly used for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost-effective. In the current study, the authors outline a conceptual model for evaluating the cost-effectiveness of cancer navigation programs. They describe how this model is being applied to the Patient Navigation Research Program, a multicenter study supported by the National Cancer Institute's Center to Reduce Cancer Health Disparities. The Patient Navigation Research Program is testing navigation interventions that aim to reduce time to delivery of quality cancer care (noncancer resolution or cancer diagnosis and treatment) after identification of a screening abnormality. Examples of challenges to evaluating cost-effectiveness of navigation programs include the heterogeneity of navigation programs, the sometimes distant relation between navigation programs and outcome of interest (eg, improving access to prompt diagnostic resolution and life-years gained), and accounting for factors in underserved populations that may influence both access to services and outcomes. In this article, the authors discuss several strategies for addressing these barriers. Evaluating the costs and impact of navigation will require some novel methods, but will be critical in recommendations concerning dissemination of navigation programs.

Original languageEnglish (US)
Pages (from-to)5394-5403
Number of pages10
JournalCancer
Volume115
Issue number23
DOIs
StatePublished - Jan 12 2009

Fingerprint

Patient Navigation
Cost-Benefit Analysis
Neoplasms
Costs and Cost Analysis
Diagnostic Services
Delivery of Health Care
National Cancer Institute (U.S.)
Quality of Health Care
Health
Vulnerable Populations
Research
Multicenter Studies
Therapeutics

Keywords

  • Cancer
  • Cost-effectiveness
  • Modeling
  • Navigator

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ramsey, S., Whitley, E., Mears, V. W., McKoy, J. M., Everhart, R. M., Caswell, R. J., ... Mandelblatt, J. (2009). Evaluating the cost-effectiveness of cancer patient navigation programs: Conceptual and practical issues. Cancer, 115(23), 5394-5403. https://doi.org/10.1002/cncr.24603
Ramsey, Scott ; Whitley, Elizabeth ; Mears, Victoria Warren ; McKoy, June M ; Everhart, Rachel M. ; Caswell, Robert J. ; Fiscella, Kevin ; Hurd, Thelma C. ; Battaglia, Tracy ; Mandelblatt, Jeanne. / Evaluating the cost-effectiveness of cancer patient navigation programs : Conceptual and practical issues. In: Cancer. 2009 ; Vol. 115, No. 23. pp. 5394-5403.
@article{8b8c92522ab1468a93268067d4361ac0,
title = "Evaluating the cost-effectiveness of cancer patient navigation programs: Conceptual and practical issues",
abstract = "Patient navigators-individuals who assist patients through the healthcare system to improve access to and understanding of their health and healthcare - are increasingly used for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost-effective. In the current study, the authors outline a conceptual model for evaluating the cost-effectiveness of cancer navigation programs. They describe how this model is being applied to the Patient Navigation Research Program, a multicenter study supported by the National Cancer Institute's Center to Reduce Cancer Health Disparities. The Patient Navigation Research Program is testing navigation interventions that aim to reduce time to delivery of quality cancer care (noncancer resolution or cancer diagnosis and treatment) after identification of a screening abnormality. Examples of challenges to evaluating cost-effectiveness of navigation programs include the heterogeneity of navigation programs, the sometimes distant relation between navigation programs and outcome of interest (eg, improving access to prompt diagnostic resolution and life-years gained), and accounting for factors in underserved populations that may influence both access to services and outcomes. In this article, the authors discuss several strategies for addressing these barriers. Evaluating the costs and impact of navigation will require some novel methods, but will be critical in recommendations concerning dissemination of navigation programs.",
keywords = "Cancer, Cost-effectiveness, Modeling, Navigator",
author = "Scott Ramsey and Elizabeth Whitley and Mears, {Victoria Warren} and McKoy, {June M} and Everhart, {Rachel M.} and Caswell, {Robert J.} and Kevin Fiscella and Hurd, {Thelma C.} and Tracy Battaglia and Jeanne Mandelblatt",
year = "2009",
month = "1",
day = "12",
doi = "10.1002/cncr.24603",
language = "English (US)",
volume = "115",
pages = "5394--5403",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "23",

}

Ramsey, S, Whitley, E, Mears, VW, McKoy, JM, Everhart, RM, Caswell, RJ, Fiscella, K, Hurd, TC, Battaglia, T & Mandelblatt, J 2009, 'Evaluating the cost-effectiveness of cancer patient navigation programs: Conceptual and practical issues', Cancer, vol. 115, no. 23, pp. 5394-5403. https://doi.org/10.1002/cncr.24603

Evaluating the cost-effectiveness of cancer patient navigation programs : Conceptual and practical issues. / Ramsey, Scott; Whitley, Elizabeth; Mears, Victoria Warren; McKoy, June M; Everhart, Rachel M.; Caswell, Robert J.; Fiscella, Kevin; Hurd, Thelma C.; Battaglia, Tracy; Mandelblatt, Jeanne.

In: Cancer, Vol. 115, No. 23, 12.01.2009, p. 5394-5403.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Evaluating the cost-effectiveness of cancer patient navigation programs

T2 - Conceptual and practical issues

AU - Ramsey, Scott

AU - Whitley, Elizabeth

AU - Mears, Victoria Warren

AU - McKoy, June M

AU - Everhart, Rachel M.

AU - Caswell, Robert J.

AU - Fiscella, Kevin

AU - Hurd, Thelma C.

AU - Battaglia, Tracy

AU - Mandelblatt, Jeanne

PY - 2009/1/12

Y1 - 2009/1/12

N2 - Patient navigators-individuals who assist patients through the healthcare system to improve access to and understanding of their health and healthcare - are increasingly used for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost-effective. In the current study, the authors outline a conceptual model for evaluating the cost-effectiveness of cancer navigation programs. They describe how this model is being applied to the Patient Navigation Research Program, a multicenter study supported by the National Cancer Institute's Center to Reduce Cancer Health Disparities. The Patient Navigation Research Program is testing navigation interventions that aim to reduce time to delivery of quality cancer care (noncancer resolution or cancer diagnosis and treatment) after identification of a screening abnormality. Examples of challenges to evaluating cost-effectiveness of navigation programs include the heterogeneity of navigation programs, the sometimes distant relation between navigation programs and outcome of interest (eg, improving access to prompt diagnostic resolution and life-years gained), and accounting for factors in underserved populations that may influence both access to services and outcomes. In this article, the authors discuss several strategies for addressing these barriers. Evaluating the costs and impact of navigation will require some novel methods, but will be critical in recommendations concerning dissemination of navigation programs.

AB - Patient navigators-individuals who assist patients through the healthcare system to improve access to and understanding of their health and healthcare - are increasingly used for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost-effective. In the current study, the authors outline a conceptual model for evaluating the cost-effectiveness of cancer navigation programs. They describe how this model is being applied to the Patient Navigation Research Program, a multicenter study supported by the National Cancer Institute's Center to Reduce Cancer Health Disparities. The Patient Navigation Research Program is testing navigation interventions that aim to reduce time to delivery of quality cancer care (noncancer resolution or cancer diagnosis and treatment) after identification of a screening abnormality. Examples of challenges to evaluating cost-effectiveness of navigation programs include the heterogeneity of navigation programs, the sometimes distant relation between navigation programs and outcome of interest (eg, improving access to prompt diagnostic resolution and life-years gained), and accounting for factors in underserved populations that may influence both access to services and outcomes. In this article, the authors discuss several strategies for addressing these barriers. Evaluating the costs and impact of navigation will require some novel methods, but will be critical in recommendations concerning dissemination of navigation programs.

KW - Cancer

KW - Cost-effectiveness

KW - Modeling

KW - Navigator

UR - http://www.scopus.com/inward/record.url?scp=72249086567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=72249086567&partnerID=8YFLogxK

U2 - 10.1002/cncr.24603

DO - 10.1002/cncr.24603

M3 - Review article

VL - 115

SP - 5394

EP - 5403

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 23

ER -