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Differences in Healthcare Utilization Across 2 Social Health Support Modalities: Results From a Randomized Pilot

Ammarah Mahmud1,2, Edwin S Wong1,3, Cara C Lewis2

  • 1Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington.

AJPM Focus
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PubMed
Summary
This summary is machine-generated.

Local, clinic-based community resource specialists improved primary care use more than a call center for patients with social needs. This social health integration pilot showed better outpatient utilization with in-person support.

Keywords:
Social health integrationhealthcare utilizationprogram evaluation

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Area of Science:

  • Health Services Research
  • Social Determinants of Health
  • Primary Care Integration

Background:

  • Patients with social needs often face barriers to accessing care.
  • Social health integration programs aim to address these needs within healthcare settings.
  • Pilot programs are crucial for evaluating novel approaches to care delivery.

Purpose of the Study:

  • To compare utilization outcomes between clinic-based community resource specialists and a centralized call center for patients with social needs.
  • To assess the impact of different social support models on healthcare utilization.
  • To inform the development of effective social health integration strategies.

Main Methods:

  • Randomized controlled trial involving 534 participants reporting social needs.
  • Comparison of healthcare utilization outcomes over 9 months, including primary care, specialty care, emergency department, and inpatient admissions.
  • Intent-to-treat and as-treated analyses using regression models to compare intervention arms.

Main Results:

  • No significant differences in unadjusted utilization outcomes between the two support models.
  • Adjusted analyses indicated higher primary care encounters for participants receiving support from community resource specialists (95% CI=0.336, 1.746).
  • As-treated analyses revealed increased primary care encounters, specialty care encounters, and patient messages among those supported by community resource specialists.

Conclusions:

  • Clinic-based social support may enhance integration with care teams for ongoing patient needs.
  • Local, clinic-based community resource specialists demonstrated greater outpatient utilization compared to a call center model.
  • Findings support the effectiveness of integrated, clinic-based social support for improving healthcare access.