[Characteristics and effectiveness of healthcare navigators in innovation fund projects: a scoping review]

Individuals with complex healthcare needs, such as those with chronic and multiple conditions, require continuous, cross-sectoral care. However, an increasingly complex healthcare system, characterized by a strict separation between outpatient and inpatient care, hampers continuity of care and contributes to overuse, underuse, and misuse of services. Healthcare navigators ("Gesundheitslotsen") aim to address these challenges by supporting affected individuals in navigating the healthcare system.

This scoping review provides an overview of the target populations, roles, and qualifications of navigators as well as the legal framework and effectiveness of navigators studied in projects funded by the German Innovation Fund (New Forms of Care) since 2016. All projects concerning navigators listed in the Innovation Fund database with a project report available as of 1 April 2025 were included in the analysis.

A total of 31 navigator projects were identified, addressing a wide range of target groups. The most frequently targeted populations included individuals in challenging life situations (n = 10) and with cardiovascular diseases (n = 5), mental or neurological disorders (n = 5), and metabolic conditions (n = 3). Across all projects, 153 distinct endpoints were evaluated. In most cases, no effect was observed. Statistically significant positive effects were most frequently reported for patient-reported outcome measures (PROMs) (n = 21), process indicators (n = 19), and patient-reported experience measures (PREMs) (n = 10). Negative effects were primarily observed in health economic outcomes, particularly in terms of increased costs (n = 5).

Standardizing reporting on pilot projects, concisely describing activities of patient navigators, and making greater use of impact models could help to improve understanding of the effectiveness of patient navigators in the future.