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Navigating Poorly Charted Territory: Patient Dilemmas in Health Care "Nonsystems"
Shoshanna Sofaer*
* To whom correspondence should be addressed. E-mail: shoshanna_sofaer{at}baruch.cuny.edu.
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Abstract |
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American health care is complex, fragmented, and arcane rather than being patient centered. Many patients have considerable difficulty navigating this system. As a result, care is less timely, safe, effective, and efficient. Since navigation problems are more likely for those who are sicker and less educated, they contribute to inequity. Early solutions proposed for this problem focused on the use of yet another specialized professional, the "navigator," to help individuals find their way through the system so they get the care they need. The author defines the patient navigation problem and its probable consequences and argues that research and action are needed to (a) document the problem empirically, (b) identify underlying organizational structures and behaviors that can make navigation easy or difficult, and (c) assess whether and how policies, regulations, and improvement strategies can influence these structures and behaviors.
First published on December 12, 2008, doi:10.1177/1077558708327945
Medical Care Research and Review 2009;66:75S.
A more recent version of this article appeared on February 1, 2009
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