Integrated Primary Care and Social Work: A Systematic Review

Abstract

Behavioral and physical health services are increasingly being integrated, with care provided by interprofessional teams of physicians, nurses, social workers, and other professionals. The objective of this study was to describe the functions of social workers on interprofessional teams in primary care and to assess the impact of interprofessional teams that include social workers in integrated care settings. Method: We undertook a systematic review of randomized controlled trials (RCTs) of routine vs. integrated primary care where social workers served on interprofessional teams. A 5-phase search process to identify RCTs from 9 electronic databases and the gray literature published between 2000 and 2016 was used. We calculated effect sizes across identified studies and conducted 2 subsample metaanalyses for behavioral health outcomes. Results: The searches recovered 502 citations. After screening, 107 reports were retained for a full-text review, and 32 of those (from 26 RCTs) met study criteria. In the 26 RCTs, social workers engaged in 3 patient-centered activities: behavioral health treatment, care management, and referral for social services. Conclusion: Although mixed, the findings suggest that, compared to routine services, integrated primary care provided by interprofessional teams that include social workers significantly improves the behavioral health and care of patients.

The Medical Social Worker: A Neglected Ally in the Management of Patients with Burn Injuries

“…This study shows the beneficiary participation of MSW in the multidisciplinary care of patients with burn injuries. With more evidence suggesting improved outcome for patients, families and communities in integrated patient care and the added value of social workers on such healthcare teams (19,22,24), burn surgeons in similar settings are advised to get more participatory involvement of the MSW in their practice.…”

“…The MSW obtained financial support for the patients, mainly by engaging the patient's home community, ultimately lowering the cost of care. Fraser et al in their review of studies reported ten studies where social workers engaged community resources on behalf of patients and their families, and noted that seven of those studies demonstrated findings favoring integrated care (19). Without financial support, access to healthcare would have been impossible for the patients, thereby increasing their potential morbidity and mortality and escalating the attendant cost of care.…”

A Realist Synthesis of Interprofessional Collaboration in the Early Years; Becoming Familiar with Other Professionals

“…We coded a number of methodological and general IPC variables for description of the studies, including the type of design (correlational; cross-sectional; longitudinal; experimental; other); type of study (quantitative, qualitative, combination, or study is explicitly designed as a mixed methods study); sample size; study focuses on child, parent, practitioner and/or management; and the focus on the interaction between these stakeholders (e.g., child-practitioner; parent-practitioner; practitioner-practitioner; management-practitioner); type of measure(s) (interview, survey, focus group, observation, other); study participants: professionals, children and/or parents [45]. Further, we coded the sector (childcare, school, social work, youth care, other) and type of care (primary care in a community service or special care for a specific target group), and the roles of IPC [4,10]: supportive and nurturing; health education and promotion; resources and referral; assessment and monitoring.…”

The Accountable Care Workforce

“…A nurse, social worker, or medical assistant may be hired as a patient navigator, case manager, care manager, or panel manager, and their responsibilities might be identical or distinct. For example, social workers, professionals whose roles have typically been narrowly defined in health care settings, have recently become more involved partners in the ranks of health care workers; the responsibilities of these social workers are likely to bridge clinical and community settings [14]. A social worker working in a care management position might provide behavioral health treatment in a hospital, while also coordinating a necessary inspection of the rental home of a patient with chronic asthma to assess for unhealthy levels of asthma-causing mold.…”

“…A social worker working in a care management position might provide behavioral health treatment in a hospital, while also coordinating a necessary inspection of the rental home of a patient with chronic asthma to assess for unhealthy levels of asthma-causing mold. These boundary spanning roles and positions are new, and the functions, tasks, and payment mechanisms associated with these positions are not yet well-defined [14].…”