School of Social Work, University of Pittsburgh , Pittsburgh , PA , USA.
School of Social Work, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
Soc Work Health Care. 2019 Oct;58(9):885-898. doi: 10.1080/00981389.2019.1659907. Epub 2019 Sep 24.
Social workers are increasingly working in primary care clinics that provide Integrated Behavioral Healthcare (IBH) in which a patient's physical, behavioral, and social determinants of health are addressed on a collaborative team. Co-location, where care is housed in the same physical space, is a key element of IBH. Yet, little is known about the rate of social workers co-located with primary care physicians (PCPs). To identify national rates of social worker co-location, data were drawn from the Centers for Medicare and Medicaid (CMS) National Plan and Provider Enumeration System (NPPES; n = 232,021 social workers, n = 380,690 PCPs). Practice addresses were geocoded and straight-line distances between practice locations of social workers and PCPs were calculated. More than 26% of social workers were co-located with a PCP. However, in rural settings only 21% were co-located ( < .001). Co-location also varied by PCP practice size, specialty, and state. This study serves as a benchmark of the growth of IBH and continued monitoring of co-location is needed to ensure social work workforce planning and training are aligned with changing models of care. Further, identifying mechanisms to support social work education, current providers, and health systems to increase IBH implementation is greatly needed.
社会工作者越来越多地在提供综合行为健康护理 (IBH) 的初级保健诊所工作,在这些诊所中,患者的身体、行为和健康的社会决定因素在协作团队中得到解决。共同定位是 IBH 的一个关键要素,即护理位于同一物理空间中。然而,对于与初级保健医生 (PCP) 共同定位的社会工作者的比率知之甚少。为了确定全国范围内社会工作者与 PCP 共同定位的比率,数据来自医疗保险和医疗补助服务中心 (CMS) 的国家计划和提供者登记系统 (NPPES; n = 232,021 名社会工作者,n = 380,690 名 PCP)。实践地址被地理编码,社会工作者和 PCP 实践地点之间的直线距离被计算出来。超过 26%的社会工作者与 PCP 共同定位。然而,在农村地区,只有 21%的社会工作者与 PCP 共同定位 ( <.001)。共同定位也因 PCP 实践规模、专业和州而异。本研究是 IBH 发展的基准,需要继续监测共同定位情况,以确保社会工作者劳动力规划和培训与不断变化的护理模式保持一致。此外,还需要确定支持社会工作教育、现有提供者和卫生系统以增加 IBH 实施的机制。