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Table 4 WellOne primary medical and dental care, Rhode Island: description of patient navigation services and patient barriers to cancer screening

From: Improving the efficiency of integrated cancer screening delivery across multiple cancers: case studies from Idaho, Rhode Island, and Nebraska

 

Implementation (2018) (%)

Patient navigation cancer screening services provided (N=1023)

 Colorectal cancer screening only

76.1(779)

 Multiple cancer screenings (e.g., colorectal cancer, cervical, and breast cancer screenings)

16.8 (172)

 Breast cancer screening only

4.8 (49)

 Follow-up diagnostic testing for screen positivesa

1.5 (15)

 Cervical cancer screening only

0.8 (8)

Patient barriers to cancer screening identified by patient navigator (N=148)

 Financial barriers or insurance coverage issues

30.4 (45)

 Psychosocial issues (including fear)

23.6 (35)

 Transportation issues

23.6 (35)

 Family/community support issues

6.8 (10)

 Medical and mental health comorbidity or disability

6.8 (10)

 Work schedule conflicts

6.8 (10)

 System problems with scheduling care

1.4 (2)

 Literacy or language barriers

0.7 (1)

Total cost of implementation in 2018 (labor and nonlabor)b

$28,160

 Identify patients due for screening via list or provider referral

1077

 Review patient record for previous referrals, documentation of screening conversation with provider, high-risk status

2992

 Contact patient to discuss colorectal cancer and other cancer screenings when appropriate

10,293

  By phone

7899

  By mail

2394

 Document contact in Electronic Health Records

3112

 Ordering/referring patients to screenings

1317

 Following up with patients if no screening documented

1915

 Following up with patients if positive screen

957

 Nonlabor costs (e.g., materials, supplies, printing)

6497

  1. Notes: aFew positive FIT results were reported. bTotal cost refers to program costs and excludes cost of screening and diagnostic follow-up