Social work staffing may increase access, use of palliative care

There are significant increases in use of palliative care for recently hospitalized veterans when primary care teams have additional social work staffing, according to a study published online Jan. 4 in JAMA Network Open.

Portia Y. Cornell, Ph.D., from the Providence VA Medical Center in Rhode Island, and colleagues have examined the association of an intervention to increase social work staffing in Veterans Health Administration (VA) primary care teams with the use of palliative care among veterans with a recent hospitalization (91,675 inpatient episodes). The analysis included data from 71 VA primary care sites serving rural veterans (43,200 veterans).

The researchers found a mean of 14.5 individuals per 1,000 veterans (1,329 individuals in all) used palliative care after a hospital stay. After the intervention, when controlling for national time trends and veteran characteristics, there was an increase of 15.6 individuals per 1,000 veterans using palliative or hospice care after a hospital stay—a twofold difference versus the mean.

"This cohort study found significant increases in use of palliative care for recently hospitalized veterans whose primary care team had additional social work staffing. These findings suggest that social workers may increase access to and/or use of palliative care," the authors write. "Future work should assess the mechanism for this association and whether the increase in palliative care is associated with other health or health care outcomes."

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