Hardin Vicky, Tangka Florence K L, Wood Teri, Boisseau Brian, Hoover Sonja, DeGroff Amy, Boehm Jennifer, Subramanian Sujha
Little Flower Clinic, Hazard, KY, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Health Promot Pract. 2020 Nov;21(6):905-909. doi: 10.1177/1524839920954165. Epub 2020 Sep 29.
The objective of this study was to analyze the effectiveness and cost of patient incentives, together with patient navigation and patient reminders, to increase fecal immunochemical test (FIT) kit return rates and colorectal cancer screening uptake in one federally qualified health center (FQHC) in Appalachia. This FQHC is a designated homeless clinic, as 79.7% of its patient population are homeless. We collected process, outcome, and cost data from the FQHC for two time periods: usual care (September 2016-August 2017) and implementation (September 2017-September 2018). We reported the FIT kit return rate, the increase in return rate, and the additional number of individual screens. We also calculated the incremental cost per additional screen. The patient incentive program, with patient navigation and patient reminders, increased the number of FIT kits returned from the usual care period to the implementation period. The return rate increased by 25.9 percentage points (from 21.7% to 47.6%) with an additional 91 people screened at an incremental cost of $134.61 per screen. A patient incentive program, together with the assistance of patient navigators and supplemented with patient reminders, can help improve CRC screening uptake among vulnerable and homeless populations.
本研究的目的是分析患者激励措施以及患者导航和患者提醒的有效性和成本，以提高阿巴拉契亚地区一家联邦合格医疗中心（FQHC）的粪便免疫化学检测（FIT）试剂盒回收率和结直肠癌筛查接受率。该FQHC是一家指定的无家可归者诊所，其患者中有79.7%是无家可归者。我们收集了该FQHC在两个时间段的过程、结果和成本数据：常规护理期（2016年9月至2017年8月）和实施期（2017年9月至2018年9月）。我们报告了FIT试剂盒回收率、回收率的提高以及额外的个体筛查数量。我们还计算了每增加一次筛查的增量成本。患者激励计划，加上患者导航和患者提醒，增加了从常规护理期到实施期返回的FIT试剂盒数量。回收率提高了25.9个百分点（从21.7%提高到47.6%），另外有91人接受了筛查，每筛查一人的增量成本为134.61美元。患者激励计划，在患者导航员的协助下并辅以患者提醒，可以帮助提高弱势群体和无家可归者人群的结直肠癌筛查接受率。
