Effect of a Patient Navigator Program to Address Barriers to Eye Care at an Academic Ophthalmology Practice

Abstract

Purpose The aim of this study was to determine whether a patient navigator program can address patient-reported barriers to eye care and to understand patient perceptions of a patient navigator program in ophthalmology. Design This is a retrospective cohort study and cross-sectional patient survey. Subjects and Methods A cohort of patients was recruited from a single academic ophthalmology department in the Mid-Atlantic region. Patients included in the study had received referral to the patient navigator program in the first quarter of 2022. Our patient navigator program provided patients with resources to address barriers to care such as transportation and financial assistance. Outcomes of the study included indications for referral, case resolution rate, and patient satisfaction. Results In total, 130 referrals for 125 adult patients were included. The mean ± standard deviation age was 59 ± 17 years, 54 (44%) were male, 77 were white (62%), and 17 patients (14%) were uninsured. Common reasons for referral were transportation (52, 40%), insurance (34, 26%), and financial assistance (18, 14%). Among the 130 cases referred, 127 (98%) received an intervention from the patient navigator, who was able to resolve the referring issue in 90% of cases (117/130). Among 113 patients contacted for a follow-up telephone survey, 56 (50%) responded. Patients rated the program highly at a mean Likert rating of 4.87 out of 5. Moreover, 72% (31/43) of respondents stated their interactions with the patient navigator assisted them with taking care of their eyes. Conclusions A patient navigator program can address barriers to eye care by connecting patients with community resources.

Keywords: access to care; barriers to care; outcomes research; patient navigator; social determinants of health.

Fig. 1

Flowchart of patient referrals and intervention outcomes. Patients received referral to the patient navigator for self-identified issues and underwent patient navigator intervention. Case resolution status was documented.

Fig. 2

Reasons for referral to the patient navigator and case outcomes (n = 130 referrals). Patients were most commonly referred to the patient navigator for transportation concerns, insurance issues, and assistance with medical appointments and equipment. Additional reasons for referral included financial assistance, lack of utilities or housing, and assistance with low vision or disability resources. The status of case resolution is shown.