Many of the most vulnerable patients have difficulty accessing and navigating the complex U.S. health care delivery system. Nurse patient navigators can play a unique role in improving health outcomes for underserved populations in a changing health care environment.
Health disparities are inequalities in health outcomes within and across communities, as defined by social, demographic, environmental, and geographic attributes. Many different segments of our society are affected by disparities, including racial and ethnic minorities, residents of rural areas, women, children, elderly, and persons with disabilities.
Patient navigators can not only facilitate improved health care access and quality for underserved populations through advocacy and care coordination, but they can also address patient issues that often lead to avoidance of health problems and non-compliance with treatment recommendations.
By addressing many of the inconsistencies associated with language and cultural differences, nurse patient navigators can foster trust and empowerment within the communities they serve. Patient navigators can help bridge the gaps for underserved groups and bring them closer to compliance.
Unfortunately, communities with the highest proportions of racial and ethnic minorities are considered among the most vulnerable to reduced health care access and quality. These communities also tend to be burdened with other socioeconomic barriers to care, including high rates of uninsured and medically indigent populations.
Nurse patient navigators help facilitate evidence-based guidelines for disease prevention and early detection. Appropriate mammography utilization has been shown to be of particular importance to minorities—most specifically black women, who are often less likely than white women to receive adequate screening and follow-up diagnostic mammography, and have a higher prevalence of breast cancer.
Women who are immigrants and those with lower incomes, with less education, without insurance, and lacking a primary care provider are less likely to get mammograms or cervical cancer screenings, but continue to have high rates of mortality.
These barriers to care, particularly language and communication, are also evident in the continuum of care for other cancers, including colorectal and lung cancers. In addition to racial and ethnic minorities, low-income individuals, women, children, young adults, the elderly, residents of rural areas, and individuals with disabilities or special health care needs may potentially benefit from individualized assistance to overcome health care system barriers and facilitate timely access to quality medical and psychosocial care from pre-diagnosis through recovery.
Patient navigators not only assist with access to care and coordination, they also play an important role in helping patients gain consistent access to insurance through publicly-funded programs such as Medicaid, as well as helping them to remain consistently insured.
Navigators are uniquely positioned to play an integral role in the changing environment of health care delivery by facilitating access to care, and making sure patients are covered. Navigators can also play a role in advising patients—particularly those facing severe health literacy issues—in their selection of health insurance plans and in completing necessary applications.
Nurse patient navigators have the potential to help in delivering better quality and more efficient care and ensuring that access to care is for all. Using a biopsychosocial approach to providing a comprehensive range of health care services and support, patient navigators represent a potentially powerful tool in the health care system to combat health disparities.
Does your organization utilize patient navigators? Are you noticing any difference in levels of patient satisfaction? Leave us a comment!