Cornell Portia Y, Halladay Christopher W, Ader Joseph, Halaszynski Jaime, Hogue Melinda, McClain Cristian E, Silva Jennifer W, Taylor Laura D, Rudolph James L
Portia Y. Cornell ( portia. cornell@va. gov ) is a health science specialist in the Center of Innovation for Long-Term Services and Supports (COIN-LTSS), Providence Veterans Affairs (VA) Medical Center, and an investigator of health services, policy, and practice at Brown University, in Providence, Rhode Island.
Christopher W. Halladay is an analyst in the COIN-LTSS, Providence VA Medical Center.
Health Aff (Millwood). 2020 Apr;39(4):603-612. doi: 10.1377/hlthaff.2019.01589.
While an emerging body of evidence suggests that medical homes may yield more benefits than traditional care models do, the role of social workers within medical homes has yet to be evaluated separately. We assessed the impact of an initiative to add social workers to rural primary care teams in the Veterans Health Administration on patients' use of social work services, hospital admissions, and emergency department visits. We found that introducing a social worker increased social work encounters by 33 percent among all veterans who received care. Among high-risk patients, we observed a 4.4 percent decrease in the number of veterans who had any acute hospital admission and a 3.0 percent decrease in veterans who had any emergency department visit, after the introduction of a social worker. Investing in social workers is a key strategy for addressing the social determinants of health and managing care coordination for high-risk, high-need populations.
虽然越来越多的证据表明，与传统护理模式相比，医疗之家可能带来更多益处，但医疗之家中社会工作者的作用尚未单独评估。我们评估了一项在退伍军人健康管理局农村初级保健团队中增加社会工作者的举措对患者使用社会工作服务、住院和急诊就诊的影响。我们发现，在所有接受护理的退伍军人中，引入一名社会工作者使社会工作接触增加了33%。在高危患者中，引入社会工作者后，我们观察到有急性住院的退伍军人数量减少了4.4%，有急诊就诊的退伍军人数量减少了3.0%。投资于社会工作者是解决健康的社会决定因素以及管理高危、高需求人群护理协调的关键策略。
