Factors associated with patient navigators' time spent on reducing barriers to cancer treatment

Patient navigator programs were established to mitigate barriers to cancer care, especially among underserved populations in 3 community hospitals in western Pennsylvania. This study was designed to determine and compare the time spent to enroll patients recently diagnosed with any type of cancer, the characteristics of enrolled patients, the types of barriers to treatment and the time it took patient navigators to address barriers. At enrollment, 253 (85%) of 299 enrollees reported barriers, most frequently problems with insurance and out-of-pocket expenses (31.5%) and transportation (24.6%). Navigators spent an average of 2.5 hours per patient. They spent significantly more time helping uninsured than insured patients and helping patients at the inner-city site. The most time was spent on financial problems (169 minutes), transportation problems (74 minutes), end-of-life issues (65 minutes), arrangement for dependent care (60 minutes), scheduling of appointments (34 minutes) and assistance with activities of daily living (24 minutes). Overall, financial barriers were the most often reported and the most time consuming. Patient navigators assisting cancer patients, especially the poor and underserved, will require significant time to address patients' financial and other barriers to care. This information will be helpful in the allocation of staff time and case loads for future programs.