University of Medicine and Dentistry, New Jersey Medical School, Newark, NJ, USA.
Cancer. 2011 Aug;117(15 Suppl):3543-52. doi: 10.1002/cncr.26264.
Despite many important efforts to increase equity in the US health care system, not all Americans have equal access to health care-or similar health outcomes. With the goal of lowering costs and increasing accessibility to health care, the nation's new health care reform legislation includes certain provisions that expand health insurance coverage to uninsured and underinsured populations, promote medical homes, and support coordination of care. These provisions may help narrow existing health care disparities. Many of the most vulnerable patients, however, may continue to have difficulty accessing and navigating the complex US health care delivery system. This article explores the unique role that patient navigation can play in improving health outcomes for racial and ethnic minorities, as well as other underserved populations, in the context of a changing healthcare environment. 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 deep-rooted issues related to distrust in providers and the health system that often lead to avoidance of health problems and non-compliance with treatment recommendations. By addressing many of the disparities associated with language and cultural differences and barriers, patient navigators can foster trust and empowerment within the communities they serve. Specific patient navigator activities are discussed, and metrics to evaluate program efforts are presented.
尽管美国医疗保健系统做出了许多重要努力来提高公平性，但并非所有美国人都能平等获得医疗保健服务或获得相似的健康结果。为了降低成本并增加医疗保健的可及性，国家新的医疗改革立法包括某些规定，扩大了对未参保和参保不足人群的医疗保险覆盖范围，促进医疗之家，并支持医疗保健的协调。这些规定可能有助于缩小现有的医疗保健差距。然而，许多最脆弱的患者可能仍然难以获得和驾驭复杂的美国医疗保健提供系统。本文探讨了在不断变化的医疗保健环境中，患者导航员在改善少数族裔和其他服务不足人群的健康结果方面可以发挥的独特作用。患者导航员不仅可以通过倡导和护理协调来促进服务不足人群获得更好的医疗保健机会和质量，还可以解决与提供者和医疗体系不信任有关的深层次问题，这些问题常常导致人们回避健康问题和不遵守治疗建议。通过解决与语言和文化差异以及障碍相关的许多差异，患者导航员可以在他们服务的社区中建立信任和赋予权力。讨论了具体的患者导航员活动，并提出了评估计划工作的指标。
