, Volume 1, Issue 2, pp 110-119
Date: 02 May 2014

Impact of Project SCOPE on Racial/Ethnic Disparities in Screening Colonoscopies

Abstract

Background

A federally funded demonstration project (Project SCOPE) was conducted to develop a model for delivering screening colonoscopy to underinsured patients in Suffolk County, NY. The recruitment model featured collaboration between Stony Brook University Medical Center and the Suffolk County Department of Health Services’ network of community health centers; bilingual patient navigators, and reimbursement of physicians and the hospital at Medicare rates.

Methods

We conducted a retrospective analysis of all (11,752) colonoscopies performed at Stony Brook Medicine, during the pre-SCOPE time period (2003–2004), during SCOPE period (2007–2008), and post-SCOPE (2010–2011), to measure the impact of SCOPE on reducing racial and ethnic disparities. Multiple logistic regression models were used to compare the likelihood of a patient being Hispanic or African American after adjusting for potential covariates.

Results

The numbers of Hispanics undergoing colonoscopies were 146 (4.3 %), 506 (12.3 %), and 262 (6 %) during the pre-SCOPE, SCOPE, and post-SCOPE time periods. The numbers of African Americans were 166 (5.1 %), 298 (7.2 %), and 255 (5.8 %). The odds ratio (OR = 1.4, 95 % CI = 1.06–1.83, p = 0.014) of a screening colonoscopy patient being Hispanic during the Project SCOPE period compared to the post-SCOPE period remained significant after taking into consideration the other covariates, such as diabetes, smoking, and insurance status.

Conclusions

Project SCOPE had a significant impact on increasing the proportion of Hispanics undergoing screening colonoscopies. Factors such as bilingual patient navigators, in addition to removing financial barriers, may have contributed to the increase.