Exploring the roles, functions, and background of patient navigators and case managers: A scoping review

Kelly, Katherine; Doucet, Shelley; Luke, Alison

doi:10.1016/j.ijnurstu.2019.05.016

Cited by 83 publications

(133 citation statements)

References 132 publications

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“…Interventions involving a navigational service, de ned as the assessment and alleviation of barriers to adequate health care by a trained lay person (6) , appear promising to improve access to PHC for various vulnerable sub-population groups, such as socially disadvantaged patients (7) , and to reduce socioeconomic disparities in healthcare (6) . Studies have shown that navigational services improve family physician a liation for low-income and underserved homeless patients (8) , contribute to reduced emergency room use by disadvantaged patients (9) and associated costs (10) , and facilitate the work of primary care teams by establishing better communication between the patient and the medical team (9) . Socially disadvantaged patients have had positive experiences with navigational services related to the emotional support received (6) as well as to the presence, availability, and competence of the person providing the service (6,10) .…”

Section: Navigational Servicesmentioning

confidence: 99%

“…Studies have shown that navigational services improve family physician a liation for low-income and underserved homeless patients (8) , contribute to reduced emergency room use by disadvantaged patients (9) and associated costs (10) , and facilitate the work of primary care teams by establishing better communication between the patient and the medical team (9) . Socially disadvantaged patients have had positive experiences with navigational services related to the emotional support received (6) as well as to the presence, availability, and competence of the person providing the service (6,10) .…”

Section: Navigational Servicesmentioning

confidence: 99%

“…The second category of navigational services includes all services that help patients on a relational or interpersonal level. Helping with decision-making (16) ; supporting follow-up care (10) ; and providing emotional support by responding to emotional distress, listening supportively, and providing comfort (6,15) are in this category. Both types of service are delivered by various practitioners with or without professional and/or clinical expertise (e.g.…”

Section: Navigational Servicesmentioning

confidence: 99%

“…Both types of service are delivered by various practitioners with or without professional and/or clinical expertise (e.g. nurses, social workers, health educators, community health workers, medical assistants, or volunteers) (10) .…”

Section: Navigational Servicesmentioning

confidence: 99%

“…A better understanding of the expectations of socially disadvantaged patients could help decision-makers design, implement, and improve PHC navigation programs (10) . The purpose of our study was to describe and better understand the needs and expectations of these patients regarding a navigational service.…”

Section: Navigational Servicesmentioning

confidence: 99%

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Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Piemeu

Loignon

Dionne

et al. 2020

Preprint

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Background: Primary healthcare is the main entry to the health care system for most of the population, even for specialized care. In 2014, it was estimated that about 25% of the population in Quebec (Canada) did not have a regular primary healthcare provider. In 2017, after the introduction of a centralized waiting list to enroll unattached patients with a family doctor, nearly 540,000 patients, many of whom were socially disadvantaged, remained on the list. Socially disadvantaged patients often have more health problems, more complex care needs, and more difficult to accommodate life situations (e.g. two or more jobs, no work accommodation, care responsibilities, low income, lack of social network). They can also lack the skills needed to navigate a constantly evolving and complex healthcare system and, consequently, misuse the system. To overcome this problem, a partnership of health system managers, family physician leaders, community agents, and researchers designed, implemented, and evaluated a navigational support initiative. This study aimed to describe and understand the expectations and needs of socially disadvantaged patients towards navigational support interventions to improve their access to healthcare. Methods: A descriptive qualitative study rooted in an international multi-site participatory study (IMPACT) was conducted with socially disadvantaged patients. Semi-structured individual face-to-face and telephone interviews were conducted with patients recruited at universal public primary health care clinics in Montérégie, some of whom received the evaluated navigational service. A thematic analysis was performed using NVivo 11 software. Results: Sixteen patients living in socially deprived contexts were recruited. Three main expectations of patients for navigational support were identified: communication expectations (support to understand providers and to be understood by them, provision of communication tips, and help to improve communication between providers); relational expectations (emotional or psychosocial support); and pragmatic expectations (information on available community resources, information about the clinic, tips and tools for medical appointments, and physical support to navigate the health care system).Conclusions: Our study contributes to the literature by identifying the many expectations socially disadvantaged patients have related to navigational services. This information can be used for navigational intervention design.

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Section: Navigational Servicesmentioning

confidence: 99%

Section: Navigational Servicesmentioning

confidence: 99%

Section: Navigational Servicesmentioning

confidence: 99%

Section: Navigational Servicesmentioning

confidence: 99%

Section: Navigational Servicesmentioning

confidence: 99%

See 3 more Smart Citations

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Piemeu

Loignon

Dionne

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

Patient navigator programmes for children and adolescents with chronic diseases

Lalji

Francis

Khalid

et al. 2021

Cochrane Database of Systematic Reviews

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Associations among navigational support and health care utilization and costs in patients with advanced cancer: An analysis based on administrative health insurance data

et al. 2023

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Background Fragmented and complex healthcare systems make it difficult to provide continuity of care for patients with advanced cancer near the end of life. Nurse‐based cross‐sectoral navigation support has the potential to increase patients' quality of life. The objective of this paper was to evaluate associations between navigation support and health care utilization, and the associated costs of care. Methods The evaluation is based on claims data from 37 statutory health insurance funds. Non‐randomized recruitment of the intervention group (IG) took place between 2018 and 2019 in four German hospitals. The comparison group (CG) was defined ex post. It comprises nonparticipating clients of the involved health insurance funds matched on age, gender, and diagnosis in a 1:4 ratio to the IG. Healthcare resource utilization was compared using incident rate ratios (IRRs) based on negative binomial regression models. Linear mixed models were performed to compare differences in lengths of hospital stays and costs between groups. Results A total of 717 patients were included (IG: 149, CG: 568). IG patients showed shorter average lengths of hospital stays (IG: 11 days [95% CI: 10, 13] vs. CG: 15 days [95% CI: 14, 16], p < 0.001). In the IG, 21% fewer medications were prescribed and there were on average 15% fewer outpatient doctor contacts per month. Average billed costs in the IG were 23% lower than in the CG (IG: 6754 EUR [95% CI: 5702, 8000] vs. CG: 8816 EUR [95% CI: 8153, 9533], p < 0.001). Conclusions The intervention was associated with decreased costs mainly as a result of a non‐intended navigation effect. The social care nurses had navigated patients within the hospital early, needs‐oriented and effectively but interpreted their function less cross‐sectorally. Linkage of hospital‐based navigators with the outpatient care sector needs further exploration.

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Exploring the roles, functions, and background of patient navigators and case managers: A scoping review

Cited by 83 publications

References 132 publications

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Patient navigator programmes for children and adolescents with chronic diseases

Associations among navigational support and health care utilization and costs in patients with advanced cancer: An analysis based on administrative health insurance data

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