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Time Contribution of Social Workers in Care Management: Value for Older Adults
Jeannine M Rowe1, Victoria M Rizzo, Suk-Young Kang
1Jeannine M. Rowe, PhD, MSW, is Associate Professor of Social Work at the University of Wisconsin-Whitewater. Dr. Rowe examines the impact of social work and interprofessional interventions in health care and aging and assists community-based agencies with the implementation of new and innovative practices. Victoria M. Rizzo, PhD, LCSW-R, is an Associate Professor of Social Work at the University of Albany School of Social Welfare-State University of New York, Distinguished Scholar and Fellow of the National Academies of Practice Social Work, and Hartford Geriatric Social Work Faculty Scholar. Her work examines the impact of interprofessional interventions including social workers on older adults coping with chronic illnesses and the implications of health care policy and financing on the provision of these services to older adults. Suk-Young Kang, PhD, MSW, is Associate Professor and Hartford Geriatric Social Work Faculty Scholar in the Department of Social Work, College of Community and Public Affairs, Binghamton University. His research areas include family caregiving, mental health, and health care utilization among older Asian American immigrants. Previously, he has worked in direct practice with older immigrants in Chicago. Rebekah Kukowski, LCSW, is a PhD candidate in Community Research and Action, College of Community and Public Affairs, Binghamton University. She serves as an interdisciplinary research assistant in the Department of Social Work, examining the intersections of social work interventions, social determinants of health, and health outcomes. Bonnie Ewald, BS, is Program Coordinator with the Center for Health and Social Care Integration and Department of Social Work and Community Health, Rush University Medical Center, Chicago, IL. In this role, she supports the development and implementation of evidence-based care management models and advances policy advocacy efforts to break down barriers to care. Michelle Newman, MPH, is Program Manager in the Department of Social Work and Community Health, Rush University Medical Center, Chicago, IL. In this role, she manages grants and oversees departmental operations. Robyn Golden, MA, LCSW, is Associate Vice President of Population Health and Aging at Rush University Medical Center, Chicago, IL. She holds academic appointments in the Departments of Medicine, Nursing, Psychiatry, and Health Systems Management. Ms. Golden focuses on program development, interprofessional education, research, and policy to improve health and well-being.
Purpose Of The Study:
The purpose of this study was to examine the time contribution of social workers in delivering AIMS (Ambulatory Integration of the Medical and Social), a care management protocol designed to address patients' nonmedical needs, and the association of time contribution with patients' depression outcomes.
Primary Practice Setting:
The study was conducted in 6 primary care provider clinics housed in a large, urban academic medical center located in the Midwestern United States.
Methodology And Sample:
A longitudinal, quasi-experimental study employing survey procedures and a retrospective review of patient records was conducted. The study included 340 patients 50 years and older with unmet nonmedical needs. Half of the patients received AIMS, which was delivered by social workers. The other half received usual care (UC), which was delivered by other health care providers.
Results:
Chi-square analysis and independent-samples t tests were performed to compare time spent addressing nonmedical needs with differences in patients' depression levels at 6 months postenrollment. The findings reveal that social workers spend significantly more time with patients than UC providers addressing patients' nonmedical needs (p < .0001). At 6 months postintervention, reduced levels of depression were observed for AIMS patients when compared with UC patients (p = .026).
Implications For Care Management Practice:
Including social workers as part of health care teams is valuable. Time spent with patients and engaging in care management activities to support patients' needs is linked with positive health outcomes. Given the benefits of care management, opportunities for reimbursement are enhanced.
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