Jan 9, 2020 - Health

A care model for the sickest patients doesn't work

Bob Herman

Empty beds in a hospital emergency room. — An emergency room is a common site for "superutilizers." Photo: Leonard Ortiz/Digital First Media/Orange County Register via Getty Images

Providing close follow-up care from a team of clinical and social workers to the sickest, most vulnerable patients does not reduce hospital readmissions, a new study in the New England Journal of Medicine concludes.

Why it matters: Many doctors and scholars viewed this approach as a promising way to improve care and save money, but it doesn't appear to do either.

What happened: Unexpected life changes or holes in social programs derailed the lives of many patients who were getting the extra help, forcing them to put their health needs on the back burner.

One patient who participated in the study told the Tradeoffs podcast that he lost contact with his social workers and providers because he was evicted and became homeless — leading to many repeat visits to his hospital.

The bottom line: Giving extra health care support to patients who are struggling with poverty, addiction, hunger and other issues is still the right thing to do.

But that model doesn't cure the deeper problems within other parts of the country's social safety net, like housing.

Go deeper: There is an important difference between "social needs" and "social determinants of health," health economist Austin Frakt wrote last year.

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A care model for the sickest patients doesn't work

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