The Impact of Patient Navigation on Health Care Utilization in Pediatric and Adolescent Gynecology: A Retrospective...

Pediatric and adolescent patients face barriers to accessing comprehensive reproductive health care. These barriers are intensified by limited infrastructure and confidentiality regulations that make scheduling, follow-up, and communication more challenging. A patient navigator (PN) position was implemented within a newly established Pediatric and Adolescent Gynecology (PAG) clinic in a large urban medical center to improve access and support confidential care. This study evaluated the impact of the PN on PAG health care utilization and investigated the effects across racial and ethnic groups and insurance types.

A retrospective cohort study was conducted using electronic medical record data from Epic SlicerDicer. Health care utilization metrics were compared for 1 year before (March 3, 2023-March 3, 2024) and 1 year after (March 4, 2024-March 4, 2025) the implementation of the PN position.

After PN implementation, total appointments increased by 39% (P < .001), completed follow-up visits increased by 65% (P < .001), and the missed appointment rate decreased by 44% (P < .001). Patients who self-identified as Asian experienced a 66% decline in missed appointment rates (P = .031), those who selected "Other" had a 49% decrease (P = .003), and the "Unknown/Declined" racial group saw a 57% decrease (P = .041). Additionally, patients with public insurance saw a 49% (P < .001) decrease.

Establishing a PN in a PAG clinic improves utilization of care, continuity, and appointment adherence. We observed significant reductions in the missed appointment rate among several racial and ethnic groups and in the underrepresented group of patients with public insurance.