Title

Assessing the Impact of Patient Navigation in a Formerly Homeless Population with Substance Abuse and Psychiatric Disabilities

Document Type

Presentation

Publication Date

12-2012

Comments

Advisor: Rickie Brawer, Department of Family and Community Medicine, Thomas Jefferson University

Abstract

Pathways to Housing (PTH-PA), a supported housing program and mental health agency, serves the chronically homeless through the Housing First model, incorporating immediate access to permanent independent scattered-site housing and supportive treatment services in areas of mental and physical health, substance abuse, education, and employment. Many PTH clients are medically complex and encounter logistical, educational, and cultural barriers that prevent the delivery of high-quality preventive, specialty, and primary health care. The purpose of this Capstone was to examine whether patient navigation is an effective strategy for addressing barriers to healthcare for the client population. The pilot study used a mixed methods research design that included EHR chart reviews to assess medical/psychosocial needs and appointment completion rates, and client surveys and interviews to assess barriers to accessing care and satisfaction with navigation services. Five intervention group participants were selected using a convenience sample based on upcoming appointments and current medical needs. Five comparison group participants were selected from the same team based on completion of a previous appointment with a team member. Comparing clients who received navigation services to those who received regular health services at PTH, interview responses suggest that clients receiving navigation services were less likely to miss specialty appointments and more likely to keep appointments for preventive services. Clients highly valued the emotional support and advocacy assistance provided, and support from the navigator while in the exam room and reported improved two-way communication with the physician. The yearly navigator caseload was determined as 24 clients. The pilot project demonstrates that navigation may improve appointment adherence and client satisfaction, and may offer additional health support services. The pilot project is an initial examination of navigation among a formerly chronically homeless population dually diagnosed with mental health and substance abuse disorders, and suggests a potential service tool for addressing client barriers and providing targeted, individualized health services.

Presentation: 33 minutes