then patient advocates or navigators are a sound investment. For patients that we studied among three academic medical centers the patients with the most severe cancer and the most hurdles socio-economically (mostly uninsured) had equal compliance with others after navigation. However, they never caught up to the commercially insured and earlier caught cancer patients who received social and nutrition, advanced nursing or clinical trial support at the most resource intense hospital.
But what this means is even one social worker intervening at a few key points can make the difference between receiving a full course of radiation therapy or not. When you are trying to cut through the weeds of health reform, some of the most basic things make the most sense. Compared to the cost of having a radiation therapy suite sitting idle because of a missed appointment and the potential additional therapy, the cost of a social worker seems to make alot of sense.
But what we cannot lose from this study to be shared in the ASCO proceedings of their recent meeting in Chicago is that lack of insurance, being of color and being poor are the primary determinants of health outcomes today in this country, as amazing as that is. Poor insurance is no panacea and does not assure access. Medicaid patients faired better than uninsured but still less well than their more well off brethren.
