How many social workers are needed in primary care? A patient-based needs assessment example

Area of Science:

• Health Services Research
• Social Work in Healthcare
• Veteran Affairs Healthcare

Background:

• Social needs significantly impact veteran health and well-being.
• Primary care settings are crucial touchpoints for identifying and addressing social determinants of health.
• Existing social work staffing models may not adequately reflect patient needs.

Purpose of the Study:

• To measure self-reported social needs in veterans within a Veterans Affairs (VA) primary care setting.
• To calculate the required social work staffing levels based on identified patient needs.
• To assess the gap between estimated staffing needs and current resources.

Main Methods:

• Utilized the Social Needs Checklist to assess 15 areas of social need in 684 veterans.
• Collected data on housing status, patient service requests, and access to other social services.
• Gathered estimates from social workers on time required for basic services.

Main Results:

• Nearly two-thirds of veterans reported financial or personal stress issues.
• Seventy-five percent of patients reported multiple social needs.
• One-third of patients explicitly requested social work services.
• Estimated social work staffing needs for high-acuity patients were 61% higher than actual staffing.

Conclusions:

• A significant unmet need for social work services exists among veterans in primary care.
• Current social work staffing levels are inadequate to address the identified patient needs.
• The study proposes a patient-needs-based methodology for estimating social work staffing requirements.