Healthcare, Social Services Partnership Could Reduce Spending

Healthcare is typically segmented into silos, despite efforts to increase collaboration between physicians, specialists, nurses, and other providers. Findings from a new study published by Health Services Research suggest that integrating social services into healthcare may be an effective way to improve patient outcomes while reducing costs.

In the study, the authors aimed to understand how healthcare providers and social services workers coordinate in communities in which healthcare utilization is low among older patients, who are more likely to drive spending. Previous studies have shown that housing instability, poor nutrition, lack of transportation, and loneliness can worsen conditions and increase spending.

The investigators looked at communities that performed very well or very poorly on measures of avoidable healthcare utilization and costs for this population.

The team of researchers analyzed Hospital Service Areas and evaluated them on ambulatory care sensitive hospitalizations, all-cause readmission rates, and average reimbursements per Medicare beneficiary.

Included in the study were the 10 highest-performing and 6 lowest-performing hospitals. The authors then conducted on-site visits and interviews with 245 individuals from the hospitals, social service organizations, and local governments.

In high-performing communities, healthcare and social services organizations frequently collaborated to determine problems that are facing older patients and to coordinate activities, according to the study. Low-performing areas were found to lack this collaboration.

“We found that organizations in higher performing communities regularly worked together to identify challenges faced by older adults in their areas and responded through collective action,” said lead author Amanda Brewster, PhD.

The authors discovered that high-performing communities achieved collective action among healthcare and social services organizations and were able to match patients in the hospital with necessary social services, according to the study.

Despite all high-performing communities achieving this, the investigators noted that they all did so in different ways. This highlights how a single solution may not promote coordination between the entities and that local attention to the issues may be required for improvement, according to the authors.

“Our results suggest that structures and norms which foster collective action among health care and social service agencies serving older adults, and partnerships by which hospitals match complex patients to social services are likely to be important to improving outcomes for high-cost, high-need individuals,” the authors wrote.