Impact of a Novel Social Work Program on Access to Tertiary Care

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Impact of a Novel Social Work Program on Access to Tertiary Care


Journalannals of global health
Article typeJournal research article – Clinical research
Publication date – Apr – 2022
Authors – Athanasios Burlotos, Paola Alejandra Vargas Díaz, Manuel Alejandro Hernández Pacheco, Lorena Daniela Ponce de León Angel, Miriam Morales Camas, Jesús Sepulveda-Delgado, José Manuel Pérez-Tirado, Santiago Ortiz-Barragan, Anthony T. Fuller, Gustavo Nigenda
Keywordshealth equity, mexico, public health sector, Right to Healthcare (RTHC)
Open access – Yes
SpecialityOther
World region Northern America
Country: Mexico
Language – English
Submitted to the One Surgery Index on April 16, 2022 at 8:38 am
Abstract:

Background: In the movement for global health equity, increased research and funding have not yet addressed a shortage of evidence on effectively implementing context-specific interventions; one unmet need is facilitating access to specialty care within the public health sector in Mexico. Compañeros en Salud has been piloting a novel program, called Right to Healthcare (RTHC), to increase access to specialty care for the rural poor in Chiapas, Mexico. The RTHC program incorporates social work, patient navigation, referrals, direct economic support, and accompaniment for patients.

Objectives: This study evaluates the effectiveness of the RTHC program. Primary outcomes analyzed included acceptance of any referral and attendance of any appointment. Secondary outcomes included acceptance of the first referral and rate of appointment attendance for patients with an accepted referral.

Methods: Using referral process data for the years 2014 to 2019 from a public tertiary care hospital in Chiapas, 91 RTHC patients were matched using 2:1 optimal pair matching with a control cohort balancing covariates of patient age, sex, specialty referred to, level of referring hospital, and municipality.

Findings: RTHC patients were more likely to have had an accepted referral (OR 17.42, 95% CI 3.68 to 414.16) and to have attended an appointment (OR 5.49, 95% CI 2.93 to 11.60) compared to the matched control group. RTHC patients were also more likely to have had their first referral accepted (OR 2.78, 95% CI 1.29 to 6.73). Among patients with an accepted referral, RTHC patients were more likely to have attended an appointment (OR 3.86, 95% CI 1.90 to 8.57).

Conclusions: The results demonstrate that the RTHC model is successful in increasing access to specialty care by both increasing referral acceptance and appointment attendance.

OSI Number – 21561

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