Practice Matters

News from Lola Butcher about health policy and practice management issues of importance to oncologists

Thursday, January 2, 2014

Nurse navigators are cost-effective

Patient navigation in cancer care has caught on like wildfire (see Eric Rosenthal’s great OT series here) in recent years, but it has not been subject to a randomized controlled trial—until now.


A study at Seattle-based Group Health found that patients supported by a nurse navigator soon after a cancer diagnosis  had better experiences -- particularly in health information, care coordination, and psychological and social care -- than those who did not.


The study, reported in the current issue of the Journal of Clinical Oncology, included patients with breast, colon/rectal, and lung cancer. In most patients, the costs of patient care after diagnosis did not differ significantly between the navigated patients and the control group; however, lung cancer patients who had a nurse navigator had costs that, on average, were $6,852 less than non-navigated peers.


Ed Wagner, MD, MPH, a senior investigator at Group Health Research Institute, headed the study, which included 251 newly diagnosed patients, half of whom were assigned to an oncology nurse navigator who worked with them for four months. During that time, the navigator contacted the patient an average of 18 times, including at least one in-person meeting and weekly phone calls. 


Even eight months after the navigators’ work ended, some of the beneficial effects to patients persisted. “That suggests that the nurse navigators helped patients to develop the confidence and skills to manage their illness and treatment more effectively,” Dr. Wagner said.