Primary care-based patient navigation can reduce healthcare disparities

A new research study conducted by Boston University School of Medicine (BUSM) shows that patient navigation services significantly improve biennial mammography screening rates among inner city women. The results, published online in the Journal of General Internal Medicine, indicate the importance of patient navigation in reducing health disparities in vulnerable patient populations.

Breast cancer is the second leading cause of cancer death in women, with 40,170 deaths in the United States in 2009. Lower mammography screening rates among minority and low income women contributes to the increased morbidity and mortality from breast cancer. According to the American Cancer Society, an estimated 5,320 new cases of breast cancer will be diagnosed and an estimated 780 women will die from breast cancer in Massachusetts during 2010.

The study was conducted over a nine-month period and involved 3,895 Boston Medical Center (BMC) general internal medicine primary care practice female patients between the ages of 51-70. Patient navigation services consisted of phone calls and reminder letters to identify the barriers to care and aid in directly scheduling mammograms. At the end of the nine-months, mammography adherence rates increased to 87 percent in those that received patient navigation with no change from the baseline adherence rates of the non navigated group (76 percent). Patient navigation also increased adherence rates across all languages, races, insurance and education groups.

"Primary care-based patient navigation is a valuable intervention to help reduce health care disparities, especially in vulnerable patient populations served by safety net hospitals like BMC," said Christine Phillips, MD, an assistant professor of medicine at BUSM and a physician in the department of general internal medicine at BMC, who led the study. "We need to explore ways to help sustain such programs in resource-poor communities and integrate them into our current Medical Home in order to provide the highest quality of care for patients."