December 2017 Research Round-Up

Below we highlight recent literature on screening for and/or addressing social needs in clinical settings. Find these and many more in our searchable Evidence Library. 

Social Work’s Role in Medicaid Reform: A Qualitative Study
Bachman, Wachman, Manning, et al. | American Journal of Public Health
This qualitative study investigates the role of social workers in Medicaid reform efforts through semistructured interviews with 46 stakeholders from 10 states. The authors found that while social workers are often involved in practice-level reform efforts, they are less likely to be involved in systems-level efforts.

Accelerating the Implementation of Social Determinants of Health Interventions in Internal Medicine
Byhoff, Freund, & Garg | Journal of General Internal Medicine
The authors articulate the importance of routine screening and referral interventions for social determinants of health (SDH) in health care delivery and recommend five actionable steps to accelerate the adoption of SDH interventions in internal medicine practice.

Long-term Impact of a Postdischarge Community Health Worker Intervention on Health Care Costs in a Safety-Net System
Galbraith, Meyers, Ross-Degnan, et al. | Health Services Research
This randomized evaluation finds that a post-hospital discharge outreach program involving patient navigators who provided coaching and helped with medical needs, transportation to outpatient appointments, connections to services, and health insurance problems reduced costs per patient by 26% for older patients but did not have an impact on younger patients.

Evaluation of Housing for Health Permanent Supportive Housing Program
Hunter, Harvey, Briscombe & Cefalu | RAND Corporation
This report summarizes the results of an evaluation of the Los Angeles County Department of Health Services’ (DHS) Housing for Health (HFH) program, which provides supportive housing to DHS patients with complex medical and behavioral health issues who are experiencing homelessness. Evaluators found that the program dramatically reduced service use, especially medical and mental health services, resulting in net cost savings of 20 percent.

Using Case Management in a Universal Health Coverage System to Improve Quality of Life of Frequent Emergency Department Users: A Randomized Controlled Trial
Iglesias, Baggio, Moschetti, et al. | Quality of Life Research
This randomized controlled study found that case management improved patients’ social needs and physical environment factors for frequent users of emergency department services in Lausanne, Switzerland.

Enhancing Administrative Data to Predict Emergency Department Utilization: The Role of Neighborhood Sociodemographics
Lines, Rosen, & Ash | Journal of Health Care for the Poor and Underserved
This study of emergency department (ED) utilization in a Massachusetts managed care network found that people in lower-income neighborhoods have more ED visits and more primary-care sensitive ED visits than people living in higher-income neighborhoods, even after adjusting for commonly used risk factors. This suggests that expected use targets should account for neighborhood-level variables such as income, as well as other risk factors.

What Works in Inclusion Health: Overview of Effective Interventions for Marginalised and Excluded Populations
Luchenski, Maguire, Aldridge, et al. | Lancet
This review synthesizes the results of 77 systematic reviews to identify interventions with evidence of effectiveness for improving health and social determinants outcomes for ‘inclusion health’ target populations, including people with experiences of homelessness, drug use, imprisonment, and sex work.

Clinical-Community Partnerships to Identify Patients with Food Insecurity and Address Food Needs
Lundeen, Siegel, Calhoun, et al. | Preventing Chronic Disease
This landscape assessment identifies and summarizes 13 health care-based interventions that screen patients for food insecurity and connects them with food resources.

A Social Work Approach to Policy: Implications for Population Health
Miller, Bazzi, Allen, et al. | American Journal of Public Health
This article highlights ways that social workers’ perspectives could help reorient health, health care, and social policies to better reduce disparities and improve population health.

Framework for Building Primary Care Capacity to Address the Social Determinants of Health
Pinto & Bloch | Canadian Family Physician
This paper describes how an academic family health team in Toronto, Ont. implements and tests activities to help address patients’ social determinants of health through a committee that analyzes how social factors affect patients and supports the development, implementation, and testing of interventions. Current interventions include an income security health promotion service; a medical-legal partnership; a child literacy program; and an advocacy and service program to improve access to work.

Integrating Social Determinants of Health into Graduate Medical Education: A Call for Action
Siegel, Coleman, & James | Academic Medicine
The authors of this invited commentary argue that competency in recognizing and mitigating social determinants of health should become a vital component of graduate medical education in all specialties. They offer several key principles for implementing curricula focusing on these determinants.

Addressing Food Insecurity in Family Medicine and Medical Education
Smith, Malinak, Chang, Schultz, Brownell | Annals of Family Medicine
This pre-post study found that educational sessions focused on the role of food insecurity in health increased provider knowledge, resources, and willingness to discuss food insecurity with patients as well as the number of patients screened.

Health Outcomes and Costs of Social Work Services: A Systematic Review
Steketee, Ross, & Wachman | American Journal of Public Health
This systematic review of studies of the health and economic impacts of social-work involved health services identified 16 relevant studies. Most studies showed positive effects on health outcomes and cost-savings, although average study quality was fair. Variability in study methods, health problems, and cost analyses made synthesis difficult.

No Equity, No Triple Aim: Strategic Proposals to Advance Health Equity in a Volatile Policy Environment
Wilkinson, Sager, Selig, et al. | American Journal of Public Health
This commentary argues that health equity should serve as the guiding framework for achieving the Triple Aim of health care reform and outlines practical opportunities for improving care and promoting stronger efforts to address social determinants of health.

The Cost-Effectiveness Analysis of Nurse-Family Partnership in the United States
Wu, Dean, Rosen, & Muennig | J of Health Care for the Poor and Underserved
This study estimates the cost-effectiveness of the Nurse-Family Partnership, a nurse-led home visiting program that provides both health and social counseling to first time mothers. Using a simulation model, the authors found that when applied to high-risk mothers, the program would generate 0.19 quality- adjusted life years (QALYs) (95% CI = 0.09, 0.44) and a net benefit of $2,764 (95% CI =-$1,210, $7,092) per nurse-visited child.