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Impact of a Patient Navigator Program on Access to Outpatient Ophthalmic Surgery
Pooja Sree Tallapaneni1, Haniah A Zaheer1, Julie Cassidy1
1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Purpose:
To evaluate the impact of a patient navigator program on surgical completion rates and visual outcomes among ophthalmology patients.
Setting:
Tertiary academic eye institute.
Design:
Retrospective cohort study.
Methods:
Patients recommended ophthalmic surgery who were referred to a patient navigator program to address barriers to surgical care in 2023 were included. The patient navigator program provided individualized logistical, financial, and social support to facilitate surgical completion, including transportation coordination and access to financial assistance. The primary outcome was surgical completion rate. A secondary outcome was change in visual acuity and time from program referral to surgery.
Results:
In total, 82 eyes of 64 patients were referred to our patient navigator program for surgical coordination. In all, 64 of 82 eyes (78%) referred for surgery successfully underwent the recommended operation. Resolution rates were highest for patient referred for transportation needs (28 of 31, 90%) or a surgical companion (25 of 30, 83%), with more modest success for cases involving lack of insurance (8 of 15, 53%) (p<0.001). Cataract extraction was the most commonly recommended procedure (53, 65%), followed by retinal detachment repair (15, 18%). The median time from referral to surgery was 39 days (interquartile range: 12, 78), with no significant difference across surgery types (p=0.60). Among those who successfully received surgery, mean best-corrected visual acuity (BCVA) improved significantly with a mean change of -0.37 logarithm of the minimum angle of resolution (logMAR) (95% CI: -0.59 to -0.15; p<0.001) overall, with the greatest improvement observed in cataract surgery (mean change -0.44 logMAR, 95% CI: -0.67 to -0.21).
Conclusion:
A patient navigator program demonstrates potential to facilitate access to outpatient ophthalmic surgery for patients who face barriers to care. These preliminary findings support further investigation of patient navigation in ophthalmology as a strategy to enhance equitable access to outpatient surgical treatment.
