Unmet patient need in home care under managed care.

Social workers in home care agencies obtained through a national random sample responded to a mail questionnaire that examined the relationship between the frequency of discharge with unmet patient need and patient/family characteristics, agency auspice, and practice activities when social workers' assessment of patient needs and managed care payment limits conflict. Regression analysis found that the importance of social work financial planning with clients and intra-agency advocacy were significant negative contributors, and patient cognitive impairment, inadequate family care, and agency auspice were significant positive contributors to a regression model explaining 31 percent of the variance in the frequency of discharge with unmet need. Implications for practice, education, and research are discussed.

Managed care in home health: social work practice and unmet client needs.

Findings from a sample (n = 117) obtained through a survey mailed to a random sampling of social workers in home health agencies nation-wide suggest that the characteristics of patients discharged with unmet needs were psychosocial. Social work practice activities targeted transferring responsibility for care for patients from agencies and government/commercial third party payers to informal caregivers and community resources. Desired continuing education topics evidence the emphasis on effective interventions that facilitate discharge, interdisciplinary collaboration and practice evaluation.

Job satisfaction of home health social workers in the environment of cost containment.

This national survey examined the job satisfaction of 228 home health social workers in the restrictive reimbursement environment of the Medicare interim payment system. Administrators' helpfulness in resolving ethical conflicts between patient access to services and agency financial priorities contributed significantly to greater satisfaction in regression analysis. Supervisors' helpfulness in resolving the conflict moderated the difficulty of resolving the conflict.

Home health care utilization: a review of the research for social work.

The author reviewed the literature to identify the variables associated with home health care utilization using the Andersen-Newman model as a framework for analysis. Sixty-four studies published between 1985 and 2000 were identified through PUBMED, Sociofile, and PsycINFO databases. Home health care was defined as in-home skilled nursing, homemaker, mobile meals, home health aide, physical therapy, occupational therapy, or social work services.

The social worker in the emerging field of home care: Professional activities and ethical concerns.

Although home care is one of the fastest growing segments of the health care delivery system, there is little empirical data on the professional functions or ethical concerns of social workers employed in home care. To provide this information 118 social workers in proprietary and nonprofit agencies in one midwestern and one southern state were surveyed. The results indicated that social workers performed a wider array of professional functions with a more diverse population of patients than had been documented previously.