Collaboration of health care and social services may decrease medical costs

A Yale School of Public Health study finds that strengthening and better integrating social services with health care for people in need may improve health outcomes and reduce medical costs. The study-- Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs -- is published in the journal Health Services Research.

The research team sought to understand how health care and social services providers coordinate their work in communities where there is relatively low health care use amongst older adults. To do this they compared U.S. communities that were performing very well or very poorly on key measures of avoidable health care utilization and costs for older adults. In the higher performing communities, health care and social service organizations regularly collaborated to identify problems affecting older adults in their areas and coordinated their activities-such as placing staff of social service agencies on site in hospitals. Lower performing communities, on the other hand, did not generally collaborate on substantive projects.  

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.

Amanda Brewster

"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 Amanda Brewster, Ph.D., associate research scientist at the Yale School of Public Health and the study’s lead author.  

The team reviewed Hospital Service Areas (HSAs) across the United States and studied the best and worst performers in three areas: ambulatory care sensitive hospitalizations, all-cause risk-standardized readmission rates and average reimbursements per Medicare beneficiary. They selected 10 higher performing HSAs and six lower performing HSAs for inclusion in the study.  

To understand patterns of collaboration in each community, the Yale team conducted site visits and in-depth interviews with a total of 245 representatives of health care organizations, social service agencies, and local government bodies.  

Marie A. Brault Ph.D., Annabel X. Tan, M.P.H., Leslie A. Curry, Ph.D., of the Yale School of Public Health, and Elizabeth H. Bradley, Ph.D., former YSPH professor and current President of Vassar College, co-authored the study.  

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