Psychosocial problems in primary care: patient and provider perceptions.

Area of Science:

• Social Work
• Primary Care Medicine
• Health Services Research

Background:

• Primary care physicians are the initial point of contact for most Americans' healthcare needs.
• Psychosocial problems significantly increase demand for medical care in primary care settings.
• The prevalence of psychosocial issues in primary care remains understudied.

Purpose of the Study:

• To determine the types and prevalence of psychosocial problems experienced by primary care patients.
• To compare patient and provider perceptions of these psychosocial issues.
• To explore the need for social work services within primary care.

Main Methods:

• A purposive sample of 684 veterans and 59 providers at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) participated.
• The Social Needs Checklist was administered anonymously to both patients and providers.
• Patient and provider data were analyzed to compare perceptions of psychosocial problems.

Main Results:

• Patients reported an average of five psychosocial problems, with finances, personal stress, transportation, employment, and legal issues being most common.
• Thirty-two percent of patients expressed a desire for social work consultation.
• Provider estimates of patient psychosocial problems were generally lower than patient self-reports, except for nursing home placement and substance use.

Conclusions:

• Significant psychosocial needs exist among primary care patients, particularly veterans.
• A discrepancy exists between patient-reported needs and provider perceptions.
• Primary care settings present opportunities for integrated social work services to address patient psychosocial challenges.