The Impact of Social Services on the Utilization of Health Care Services
Creators: name: Chen, Mengyan
Publisher: name: IUPUI University Library
Year: 2018
Subjects: Social Work Service
Mental Health Service
Emergency Department Vists
Overuse
Hospitalization

description: Indiana University-Purdue University Indianapolis (IUPUI)
description: The unnecessary medical care causes a heavy financial burden for the patients themselves and the society, and they also negatively impact the quality of medical care. An estimated 13% to 27% of ED visits in the United States could be managed in physician offices, clinics, and urgent care centers, saving $4.4 billion annually, and 26 percent of hospitalizations were potentially avoidable at a cost of $5.6 billion in 2005. If we can help people become more aware of health care services, it could be a potentially effective way to reduce emergency service overuse. we focused on mental health service and social work service as intervention variable, preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem as outcomes to determine the impact of specific social service on utilization of specific health care service adjusting for other characteristics of patients (demographic and utilization history information). The data which involved 24074 patients was provided from and managed by the Regenstrief Institute. The date of having the specific service and the frequency of using the specific health care service per year from 2011 to 2014 for each patient was recorded as well as the baseline information including gender, age, race, primary care visit per year before 2011, ACG risk score at 2011, ED visit per year before 2011. For each of preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem, we fitted a multiple linear regression model to ascertain the effects of mental health service and social work service adjusted for the baseline information. There was a significant relationship between preventable ED visit &amp; mental health service, hospitalization due to mental health problems &amp; mental health service, as well as hospitalization due to mental health problems &amp; social work service. We found that in most situation, social services were positively associated with health care service. But in the second model which described the impact of mental health service on utilization of hospitalization due to mental health problem, receiving one mental health service can reduce the utilization of hospitalization due to mental health problem, which is as our expectation. According to our study, appropriate amount of services appears helpful on reducing the overuse of ED and hospitalization due to mental health problem. However, people who overused ED or hospitalization in the past were also more likely to be frequent service users, and they tended to continue overuse ED or Incur more hospitalization. There is a group of people who overuse ED or hospitalization without having any service. ED or hospitalization may be their first choice because of their financial condition or other factors, which makes them have no interest to take services.