Pruitt Zachary, Emechebe Nnadozie, Quast Troy, Taylor Pamme, Bryant Kristopher
1 Department of Health Policy and Management, College of Public Health, University of South Florida , Tampa, Florida.
2 Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida , Tampa, Florida.
Popul Health Manag. 2018 Dec;21(6):469-476. doi: 10.1089/pop.2017.0199. Epub 2018 Apr 17.
Recent health system innovations provide encouraging evidence that greater coordination of medical and social services can improve health outcomes and reduce health care expenditures. This study evaluated the savings associated with a managed care organization's call center-based social service referral program that aimed to assist participants address their social needs, such as homelessness, transportation barriers, and food insecurity. The program evaluation linked social service referral data with health care claims to analyze expenditures in 2 annual periods, before and after the first social service referral. Secondary data analysis estimated the change in mean expenditures over 2 annual periods using generalized estimating equations regression analysis with the identity link. The study compared the change in mean health care expenditures for the second year for those reporting social needs met versus the group whose needs remained unmet. By comparing the difference between the first and second year mean expenditures for both groups, the study estimated the associated savings of social services, after controlling for group differences. These results showed that the decrease in second year mean expenditures for the group of participants who reported all of their social needs met was $2443 (10%) greater than the decrease in second year mean expenditures for the group who reported none of their social needs met, after controlling for group differences. Organizations that integrate medical and social services may thrive under policy initiatives that require financial accountability for the total well-being of patients.
近期的卫生系统创新提供了令人鼓舞的证据,表明医疗和社会服务的更好协调可以改善健康结果并降低医疗保健支出。本研究评估了与一家管理式医疗组织基于呼叫中心的社会服务转介计划相关的节省情况,该计划旨在帮助参与者满足他们的社会需求,如无家可归、交通障碍和粮食不安全。该计划评估将社会服务转介数据与医疗保健索赔联系起来,以分析在首次社会服务转介之前和之后的两个年度期间的支出。二次数据分析使用具有恒等链接的广义估计方程回归分析估计了两个年度期间平均支出的变化。该研究比较了报告社会需求得到满足的人群与需求未得到满足的人群在第二年平均医疗保健支出的变化。通过比较两组第一年和第二年平均支出的差异,该研究在控制组间差异后估计了社会服务的相关节省情况。这些结果表明,在控制组间差异后,报告所有社会需求均得到满足的参与者组第二年平均支出的减少比报告没有任何社会需求得到满足的组第二年平均支出的减少多2443美元(10%)。整合医疗和社会服务的组织可能会在要求对患者整体福祉进行财务问责的政策举措下蓬勃发展。