Increasing patient access to social workers within primary care could lower hospitalizations and emergency department visits for higher-risk patients, according to a new study.
Researchers found hiring social workers to work in underrepresented areas increased patient social work encounters by 33% over the study period. Those encounters were associated with a 4.4% decrease in hospitalizations among 43,000 high-risk patients, and a 3% reduction in emergency department visits. The findings were published Monday in Health Affairs.
"The study suggests a lot of benefits to having additional social workers on a team," said study lead author Portia Cornell, an investigator at Brown University and a health science specialist at the Providence (R.I.) VA Medical Center.
The analysis marks the first large-scale study to primarily examine the effectiveness of social workers within a medical home. Researchers analyzed primary-care visits of more than 379,000 veterans in 93 clinic sites across 18 states between October 2016 and June 2019.
Veterans Health Administration rural clinics hired 82 social workers to fill positions and bring those clinics up to agency standards. The VHA requires clinics to have one social worker per 2,400 patients.
There was a 3.8% decrease in non-urgent ED visits, suggesting about 77% of the overall reduction in visits by high-risk veterans was in veterans who had a preventable ED visit
Overall, researchers estimated the additional social workers translated into 8,000 fewer ED visits and 9,000 fewer hospital days per year among medically high-risk veterans.
VHA social workers follow a practice model that emphasizes addressing socio-economic factors that could negatively impact patients' health outcomes, according to Cornell.
As more hospitals look to address social needs, Cornell expected social workers to take on a larger role to bridge the care gaps when there aren't enough time or resources to give patients ongoing support.
"Having enough social workers on a team who have the capacity to really provide that more intensive management results in these really measurable, bottom-line effects on patient healthcare utilization," Cornell said.
