The study aimed to examine utilisation of medical and health social work services among ageing recent and long-term immigrants, to identify barriers to service utilisation, and to examine factors related to utilisation. Participants (n = 402) recruited from a random community sample of immigrants from the former Soviet Union in Israel, aged 55 and over, residing in urban areas throughout the country were interviewed by telephone. Using an expanded framework of Andersen's behavioural model, the independent variables included predisposing, enabling and need variables, and additional variables--barriers to utilisation or difficulties encountered during utilisation of services. For multivariate analyses of the dependent variables, a linear multiple regression model was employed for utilisation of medical services and a logistic regression model for utilisation of social work services. The main findings show that utilisation rates were high for medical services, but low for social work services. Recent immigrants had similar utilisation rates of medical services but utilised more social work services than long-term immigrants. There were few barriers but numerous difficulties in utilisation of medical services, while there were barriers but negligible difficulties in utilisation of social work services. Predisposing and need variables explained utilisation of medical services, whereas a combination of predisposing, enabling and need variables explained utilisation of social work services. The findings suggest that different factors are associated with the use of non-discretionary versus discretionary (social work) services. There is a need to reduce difficulties in utilisation of medical services and to enhance awareness about health social work services among the immigrants.

The authors examined factors related to utilization of health social work services among older immigrants from the former Soviet Union and veteran residents of Israel, using Andersen's behavioral model. A sample of 476 patients age 55 and older was interviewed. The immigrants and veterans had similar backgrounds, but immigrants had fewer resources and higher need. Veteran Israelis were twice as likely to have been in contact with a hospital social worker. Factors related to seeing a social worker were male gender, social network size (no network or large network), activity limitations, and sick days. The main barriers to contacting a social worker stemmed from information problems. The findings have implications for providing services in areas with large numbers of immigrants.

Objective: To examine the associations of patients' characteristics, hospitalization factors, and the patients' or family assessment of the discharge planning process, with their evaluation of adequacy of the discharge plan. Method: A prospective study. Social workers from 11 acute care hospitals in Israel provided data on 1426 discharged patients. At 2-week postdischarge, 407 patients and 659 family members evaluated the discharge planning process (information received, involvement, influence) and adequacy. Results: More family (77%) than patients (62%) assessed the discharge planning to be adequate. Discharge process variables contributed more than patient or hospitalization characteristics to evaluation of adequacy but had a negligible mediation effect. Factors significantly associated with higher adequacy of plans were: hospital ward, receiving information, high family involvement, and discharge destination among patients; receiving of information and high patient and family involvement among family respondents. Conclusions: Social workers should actively involve patients and family in discharge planning.

This study aimed to examine the implementation, adequacy, and outcomes of discharge planning. The authors carried out a prospective study of 1,426 adult patients discharged from 11 acute care hospitals in Israel. Social workers provided detailed discharge plans on each patient. Telephone interviews were conducted two weeks post-discharge. Findings showed 40 percent of patients were referred to institutional care and 60 percent were sent home with plans to receive community services. At follow-up, the rates of implementation varied by planned services. Among patients referred to institutional care, 46 percent of those referred to nursing homes and 70 percent of those referred to rehabilitation facilities received the planned care. Of those discharged home, 65 percent received planned home attendant services and 59 percent received planned home health care. Implementation of institutional care was related to the patient's functional status and population group. Implementation of community and home services was related to age, gender, population group, and hospital department. These gaps in implementation of planned services have important policy implications. Discussion of the findings with the participating hospitals and national authorities resulted in plans to improve continuum of care.