Evaluation of an Intervention to Increase Screening Colonoscopy in an Urban Public Hospital Setting

摘要: Only 50% of New Yorkers aged 50 and over reported ever being screened for colorectal cancer by any modality according to a recent household survey. The objective this investigation was assess the impact hospital-based intervention aimed at eliminating health care system barriers timely screening Lincoln Medical Center, large, urban public hospital in one nation's poorest census tracts. We conducted retrospective analysis all colonoscopies performed an 11-month period, during which multi-pronged increase number took place. Two “patient navigators” were hired study period provide continuity colonoscopy patients. A Direct Endoscopic Referral System (DERS) also implemented. Enhancements gastrointestinal (GI) suite made improve operational efficiency. Immediately following introduction patient navigators, there dramatic sustained decline broken appointment rates both diagnostic (from 67% May 2003 5% June 2003). likelihood keeping after navigator increased nearly 3-fold (relative risk = 2.6, 95% CI 2.2–3.0). rate from 56.8 per month 119 month. coverage provided facility among persons surrounding Zip codes 5.2 15.6% (RR 3.0, 1.9–4.7). Efforts highly successful, due large part influence streamlined referral system, GI enhancements. These findings suggest that are significant health-care that, when addressed, could have on general population.