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The Effect of DOH-PCSI Patient Navigation Access Program for Breast Cancer on Quality of Care at the Medical Oncology Clinic at the Philippine General Hospital: The 1st 6 Months
Ma. Pamela D. Patdu,1 Wilfredo L. Liangco,1 Corazon A. Ngelangel,1,2 Anna Melissa S. Guerrero,3
Ma. Victoria G. Ala,3 Rachel Marie B. Rosario2 and Romeo V. Marcaida2
1Section of Medical Oncology, Department of Medicine,
College of Medicine and Philippine General Hospital, University of the Philippines Manila
2Philippine Cancer Society Inc., Manila, Philippines
3Department of Health-National Center for Pharmaceutical Access and
Introduction. Cost has become a limiting factor for indigent breast cancer patients at the Philippine General Hospital (PGH). The Department of Health-Philippine Cancer Society Inc (DOH-PCSI) Access Program for Breast Cancer Medicine provided free chemotherapy through a patient navigation system in PGH starting January 2012 to improve breast cancer treatment quality. This study looked into the differences of quality care in the non-metastatic setting among enrolled patients in the first 6 months compared to patients outside of the program from 2011-2012.
Methods. This retrospective cohort used follow-up rates and 19 quality care indicators linked to improved outcomes to look into quality of care among patients who were enrolled (n=58) and those who were not (n=118 for 2011 and 2012). Subgroup analyses compared patients in the program and those who were not included in the same period (n=28). Another analysis compared 2011 patients (n=90) with those in 2012 (n=86). Z-test for the difference of proportions was done.
Results. Attrition rate decreased from 62% in 2011 to 18% in 2012 (p<.0001). There was a significant improvement in 12 quality care indicators in the program (95% CI), with the greatest differences in the initiation of treatment (58.7%) and appropriate neo-adjuvant chemotherapy administration (58.3%). Similar trends were seen in the subgroup analyses.
Conclusion. The DOH-PCSI Access Program for Breast Cancer Medicine program improved care among breast cancer patients in PGH, noted as early as within its first six months.
Key Words: access for breast cancer medicine, patient navigation, quality care