Social workers are key to addressing social determinants of health in integrated care settings

Petruzzi, Liana; Milano, Nicole; Chen, Qi; Noel, Lailea; Golden, Robyn; Jones, Barbara

doi:10.1080/00981389.2023.2292565

Cited by 1 publication

(1 citation statement)

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“…Unsurprisingly, larger clinics were better able to provide additional support services compared to smaller clinics. Costs for patient navigation/coordination and social work are not directly billable as fee-for-service patient encounters, and therefore are better supported by clinics that use a patient-centered medical home or integrated care model [ 21 ], such as those affiliated with a hospital or large healthcare network. Additionally, patient ability to take time off work was the second most frequently indicated barrier, but only 38.7% of clinics had walk-in schedules, 35% had extended evening hours, and 34% had weekend hours.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional analysis of primary care clinics’ policies, practices, and availability of patient support services during the COVID-19 pandemic

Ratnapradipa,

Wang,

Kabayundo

et al. 2024

BMC Health Serv Res

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Background Healthcare accessibility and utilization are important social determinants of health. Lack of access to healthcare, including missed or no-show appointments, can have negative health effects and be costly to patients and providers. Various office-based approaches and community partnerships can address patient access barriers. Objectives (1) To understand provider perceptions of patient barriers; (2) to describe the policies and practices used to address late or missed appointments, and (3) to evaluate access to patient support services, both in-clinic and with community partners. Methods Mailed cross-sectional survey with online response option, sent to all Nebraska primary care clinics (n = 577) conducted April 2020 and January through April 2021. Chi-square tests compared rural-urban differences; logistic regression of clinical factors associated with policies and support services computed odds ratios (OR) and 95% confidence intervals (CI). Results Response rate was 20.3% (n = 117), with 49 returns in 2020. Perceived patient barriers included finances, higher among rural versus urban clinics (81.6% vs. 56.1%, p =.009), and time (overall 52.3%). Welcoming environment (95.5%), telephone appointment reminders (74.8%) and streamlined admissions (69.4%) were the top three clinic practices to reduce missed appointments. Telehealth was the most commonly available patient support service in rural (79.6%) and urban (81.8%, p =.90) clinics. Number of providers was positively associated with having a patient navigator/care coordinator (OR = 1.20, CI = 1.02–1.40). For each percent increase in the number of privately insured patients, the odds of providing legal aid decreased by 4% (OR = 0.96, CI = 0.92-1.00). Urban clinics were less likely than rural clinics to provide social work services (OR = 0.16, CI = 0.04–0.67) or assist with applications for government aid (OR = 0.22, CI = 0.06–0.90). Conclusions Practices to reduce missed appointments included a variety of reminders. Although finances and inability to take time off work were the most frequently reported perceived barriers for patients’ access to timely healthcare, most clinics did not directly address them. Rural clinics appeared to have more community partnerships to address underlying social determinants of health, such as transportation and assistance applying for government aid. Taking such a wholistic partnership approach is an area for future study to improve patient access.

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Section: Discussionmentioning

confidence: 99%