Department of Health Care Management, Hamburg Center for Health Economics (HCHE), University of Hamburg, Esplanade 36, 20354, Hamburg, Germany.
Department of Health Care Management, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany.
BMC Public Health. 2020 Nov 30;20(1):1827. doi: 10.1186/s12889-020-09927-4.
Non-clinical health interventions provided by the voluntary and community sector can improve patients' health and well-being and reduce pressure on primary and secondary care, but only if patients adhere to them. This study provides novel insights into the impact of doctor referrals to such services, known as social prescribing, on patients' adherence to them.
Using a negative binomial model, we analysed electronic visitor records from a community health advice and navigation service in Germany between January 2018 and December 2019 to determine whether social prescribing was associated with greater adherence to the service (measured in terms of return visits) compared to patients who self-referred. We also explored whether this effect differed according to patient characteristics.
Based on 1734 observations, we found that social prescribing was significantly associated with a greater number of return visits compared to patient self-referrals (p < 0.05). For patients who visited the service because of psychological concerns, the effect of social prescribing was lower. For all other patient characteristics, the effect remained unchanged, suggesting relevance to all other patient groups.
The results of our study indicate that social prescribing may be an effective way to facilitate adherence to non-clinical community and voluntary sector health services. This knowledge is important for policy makers who are deciding whether to implement or expand upon social prescribing schemes.
志愿和社区部门提供的非临床健康干预措施可以改善患者的健康和福祉,减轻初级和二级保健的压力,但前提是患者坚持使用这些措施。本研究首次深入探讨了医生向此类服务(称为社会处方)转介对患者坚持使用这些服务的影响。
我们使用负二项式模型,分析了德国一家社区健康咨询和导航服务在 2018 年 1 月至 2019 年 12 月期间的电子访客记录,以确定与患者自行转诊相比,社会处方是否与更高的服务依从性(以复诊次数衡量)相关。我们还探讨了这种影响是否因患者特征而异。
基于 1734 次观察,我们发现与患者自行转诊相比,社会处方与更多的复诊次数显著相关(p<0.05)。对于因心理问题而就诊的患者,社会处方的效果较低。对于所有其他患者特征,效果保持不变,这表明对所有其他患者群体都具有相关性。
我们的研究结果表明,社会处方可能是促进非临床社区和志愿部门健康服务依从性的有效方法。这一知识对决策者决定是否实施或扩大社会处方计划具有重要意义。