Rapid City, SD, United States
Rapid City, SD, United States

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Guadagnolo B.A.,University of Texas M. D. Anderson Cancer Center | Guadagnolo B.A.,Rapid City Regional Hospital | Boylan A.,John T Vucurevich Regional Cancer Care Institute | Sargent M.,John T Vucurevich Regional Cancer Care Institute | And 7 more authors.
Cancer | Year: 2011

BACKGROUND: A study was undertaken to assess patient navigation utilization and its impact on treatment interruptions and clinical trial enrollment among American Indian cancer patients. METHODS: Between February 2004 and September 2009, 332 American Indian cancer patients received patient navigation services throughout cancer treatment. The patient navigation program provided culturally competent navigators to assist patients with navigating cancer therapy, obtaining medications, insurance issues, communicating with medical providers, and travel and lodging logistics. Data on utilization and trial enrollment were prospectively collected. Data for a historical control group of 70 American Indian patients who did not receive patient navigation services were used to compare treatment interruptions among those undergoing patient navigation during curative radiation therapy (subgroup of 123 patients). RESULTS: The median number of contacts with a navigator was 12 (range, 1-119). The median time spent with the navigator at first contact was 40 minutes (range, 10-250 minutes), and it was 15 minutes for subsequent contacts. Patients treated with radiation therapy with curative intent who underwent patient navigation had fewer days of treatment interruption (mean, 1.7 days; 95% confidence interval [CI], 1.1-2.2 days) than historical controls who did not receive patient navigation services (mean, 4.9 days; 95% CI, 2.9-6.9 days). Of the 332 patients, 72 (22%; 95% CI, 17%-26%) were enrolled on a clinical treatment trial or cancer control protocol. CONCLUSIONS: Patient navigation was associated with fewer treatment interruptions and relatively high rates of clinical trial enrollment among American Indian cancer patients compared with national reports. Copyright © 2010 American Cancer Society.


Guadagnolo B.A.,University of Texas M. D. Anderson Cancer Center | Huo J.,University of Texas M. D. Anderson Cancer Center | Buchholz T.A.,University of Texas M. D. Anderson Cancer Center | Petereit D.G.,John T Vucurevich Regional Cancer Care Institute | Petereit D.G.,University of Wisconsin - Madison
Ethnicity and Disease | Year: 2014

Objective: We sought to compare hospice utilization for American Indian and White Medicare beneficiaries dying of cancer.Methods: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases to analyze claims for 181,316 White and 690 American Indian patients dying of breast, cervix, colorectal, kidney, lung, pancreas, prostate cancer, or stomach cancer from 2003 to 2009.Results: A lower proportion of American Indians enrolled in hospice compared to White patients (54% vs 65%, respectively; P<.0001). While the proportion of White patients who used hospice services in the last 6 months of life increased from 61% in 2003 to 68% in 2009 (P<.0001), the proportion of American Indian patients using hospice care remained unchanged (P=.57) and remained below that of their White counterparts throughout the years of study.Conclusion: Continued efforts should be made to improve access to culturally relevant hospice care for American Indian patients with terminal cancer.

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