Date of Conferral

2021

Degree

Ph.D.

School

Health Services

Advisor

Simone Salandy

Abstract

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 and October 1, 2016. The claims experience (represented by current procedural terminology or CPT codes) between enrollees who accessed social services (like healthy food or transportation assistance) and those who did not as well as the experience between Medicare Advantage and Medicaid enrollees were compared. The Meikirch model was the theoretical framework of the study. Study results revealed that, with a few exceptions, social service access alone was not significant. However, the combination of social service access with comprehensive case management support was significant in driving the use of preventive services in a primary care setting, particularly among female Medicare Advantage enrollees. These study results create positive social change by offering evidence as to the importance of social factors that create barriers for vulnerable populations in accessing preventive services as well as methods to integrate social support coordination with healthcare delivery for increased efficiency and improved health outcomes.

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