Gervès-Pinquié Chloé, Girault Anne, Phillips Serena, Raskin Sarah, Pratt-Chapman Mandi
Research Institute for Environmental and Occupational Health (Irset-Inserm UMR1085), Ester Team - UFR Santé - Département de Médecine, Rue Haute de Reculée, 49045, ANGERS Cedex01, France.
EA MOS 7348 - French School of Public Health, 20 avenue George Sand, 93200, Saint Denis, France.
Health Econ Rev. 2018 Jun 14;8(1):12. doi: 10.1186/s13561-018-0196-4.
Patient navigation has expanded as a promising approach to improve cancer care coordination and patient adherence. This paper addresses the need to identify the evidence on the economic impact of patient navigation in colorectal cancer, following the Health Economic Evaluation Publication Guidelines. Articles indexed in Medline, Cochrane, CINAHL, and Web of Science between January 2000 and March 2017 were analyzed. We conducted a systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment of the included studies was based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Inclusion criteria indicated that the paper's subject had to explicitly address patient navigation in colorectal cancer and the study had to be an economic evaluation. The search yielded 243 papers, 9 of which were finally included within this review. Seven out of the nine studies included met standards for high-quality based on CHEERS criteria. Eight concluded that patient navigation programs were unequivocally cost-effective for the health outcomes of interest. Six studies were cost-effectiveness analyses. All studies computed the direct costs of the program, which were defined a minima as the program costs. Eight of the reviewed studies adopted the healthcare system perspective. Direct medical costs were usually divided into outpatient and inpatient visits, tests, and diagnostics. Effectiveness outcomes were mainly assessed through screening adherence, quality of life and time to diagnostic resolution. Given these outcomes, more economic research is needed for patient navigation during cancer treatment and survivorship as well as for patient navigation for other cancer types so that decision makers better understand costs and benefits for heterogeneous patient navigation programs.
患者导航作为一种改善癌症护理协调和患者依从性的有前景的方法已得到扩展。本文根据《卫生经济评估出版指南》，探讨了确定患者导航对结直肠癌经济影响证据的必要性。对2000年1月至2017年3月期间在Medline、Cochrane、CINAHL和Web of Science上索引的文章进行了分析。我们使用系统评价和Meta分析的首选报告项目（PRISMA）指南对文献进行了系统评价。纳入研究的质量评估基于综合卫生经济评估报告标准（CHEERS）清单。纳入标准表明，论文主题必须明确涉及结直肠癌患者导航，且该研究必须是一项经济评估。检索得到243篇论文，其中9篇最终纳入本综述。9项纳入研究中有7项符合CHEERS标准的高质量标准。8项研究得出结论，患者导航计划对于所关注的健康结果无疑具有成本效益。6项研究是成本效益分析。所有研究都计算了该计划的直接成本，这些成本至少被定义为计划成本。8项综述研究采用了医疗保健系统视角。直接医疗成本通常分为门诊和住院就诊、检查和诊断。有效性结果主要通过筛查依从性、生活质量和诊断解决时间来评估。鉴于这些结果，在癌症治疗和生存期间以及针对其他癌症类型的患者导航方面，需要进行更多的经济研究，以便决策者更好地了解不同患者导航计划的成本和效益。
