Fundación para la Prevención y Tratamiento del Cáncer, Cali, Colombia.
Partners for Cancer Care and Prevention, Baltimore, Maryland, USA.
Cancer Rep (Hoboken). 2022 Sep;5(9):e1564. doi: 10.1002/cnr2.1564. Epub 2021 Nov 1.
Patient navigation is the logistical and emotional support necessary to achieve diagnostic and treatment compliance. It can improve time to diagnosis, initiation of treatment, and patient satisfaction, as well as reduce the cost of treatment. Colombia has a well-defined Cancer Control Plan, but its implementation is lacking.
To implement the first patient navigation initiative in Colombia, as part of a pilot program for the early detection of breast cancer.
The process involved assessing and addressing the barriers faced by women to access breast health care by providing training for health personnel, strengthening primary health care providers, and coordinating diverse level institutions for the provision of services. This led to the design and implementation of a navigation strategy focused on the needs of patients in Cali, Colombia and the involvement of the local health system to provide such services.
Time to diagnosis was significantly reduced; research advanced by the Colombian National Institute of Cancerology shows that the average time between the first medical consultation and diagnosis was 91 days (CI 95%: 82-97 days), while this study carried out the same process in an average of 30 days, but patients still had issues with continuity of treatment due to financial strain between healthcare providers and insurers. Navigation, however, manages to overcome many of these problems by assisting women in the clinical and administrative care processes and seeking well-being for the beneficiaries. In addition, patient navigation helped identify critical failures in care, such as fragmentation of care and excessive bureaucracy. The navigation process improved data collection and established agreements to simplify and make the delivery of care more efficient. In addition, it generated partnerships between service providers and insurers.
While several barriers and poor understanding of the navigation process still exist, a navigation program can help implement a Cancer Control Plan.
患者导航是实现诊断和治疗依从性所需的后勤和情感支持。它可以提高诊断时间、治疗启动时间和患者满意度，同时降低治疗成本。哥伦比亚有一个明确的癌症控制计划，但实施情况不佳。
在哥伦比亚实施首个患者导航计划，作为早期乳腺癌检测试点计划的一部分。
该过程涉及评估和解决女性获得乳腺保健服务的障碍，为此提供卫生人员培训、加强初级保健提供者，并协调不同层次的机构提供服务。这导致了设计和实施一种以患者需求为中心的导航策略，该策略专注于哥伦比亚卡利的患者需求，并涉及当地卫生系统提供此类服务。
诊断时间显著缩短；哥伦比亚国家癌症研究所的研究表明，从首次医疗咨询到诊断的平均时间为 91 天（95%CI：82-97 天），而本研究平均在 30 天内完成了相同的过程，但由于医疗保健提供者和保险公司之间的财务紧张，患者仍然存在治疗连续性问题。然而，导航通过协助女性进行临床和行政护理过程，并为受益人寻求福祉，成功地克服了许多这些问题。此外，患者导航有助于识别护理中的关键问题，如护理碎片化和过度官僚主义。导航过程改善了数据收集并达成了简化和提高护理效率的协议。此外，它还促成了服务提供者和保险公司之间的合作伙伴关系。
尽管仍然存在一些障碍和对导航过程的理解不足，但导航计划可以帮助实施癌症控制计划。
