Care Management For Older Adults: The Roles Of Nurses, Social Workers, And Physicians

Area of Science:

• Geriatrics
• Healthcare Management
• Social Work

Background:

• Care management programs are increasingly adopted to enhance service integration for frail older adults.
• Models suggest including registered nurses (RNs) and social workers in care management.
• A significant gap exists in the availability of these essential providers in primary care settings.

Purpose of the Study:

• To assess the prevalence of social workers and RNs in practices serving frail older adults.
• To examine the roles of social workers and RNs in care coordination and social needs assessment.
• To understand the impact of these providers on physician involvement in care management.

Main Methods:

• A 2018 national survey of 410 clinicians across 363 primary care and geriatrics practices.
• Data collected on the presence and roles of social workers and RNs.
• Analysis of physician involvement in social needs assessment and care coordination.

Main Results:

• Nearly 40% of practices lacked social workers or RNs.
• Social workers were more involved in social needs assessment, while RNs focused on care coordination.
• Physician involvement in assessment and coordination decreased when social workers or RNs were present.

Conclusions:

• The integration of social workers and RNs in care management for frail older adults is inconsistent.
• Distinct roles for social workers and RNs emerge, potentially optimizing care.
• Physician roles may shift or decrease in specific care management activities with the introduction of these professionals.