Oct. 3 (UPI) -- Providing nonmedical services in conjunction with primary care -- known as wraparound services -- resulted in a reduction in the number of hospitalizations and emergency room visits, according to a study of one system.
Researchers studied the effects of a large urban safety-net health provider that also included on-site dietetics and social work: Eskenazi Health in Indianapolis. The findings were published in the October issue of the journal Health Affairs.
Providers have been turning to nonmedical services to improve patient outcomes and reduce overall healthcare spending as "U.S. reimbursement policies are increasingly holding providers financially accountable for patients' health," said the authors, who were affiliated with the health provider as well as Indiana University School of Medicine and the School of Public Health at Indiana University -- Purdue University Indianapolis.
Studied were 14,094 patients with an mean age of 49.7 at Eskenazi Health, which began offering wraparound services in 2011. Patient records from 2006 to 2016 were studied.
Researchers calculated potential savings with an estimate of the number of hospitalizations that could have been expected among those receiving wraparound services had the services not been offered.
Wraparound services potentially saved $8.2 million from 2011 to 2016 at Eskenazi, based on median hospitalization costs. The estimate represents an average of $1.4 million to $2.4 million potential cost savings per year.
These extra services also were associated with a 5 percent reduction in the number of emergency department visits in the year after the services were provided. Potential cost savings for emergency department visits were not determined because emergency department costs were not available.
"Early intervention and effective chronic disease management are vital to keeping people out of the hospital and reducing the burden of illness on the patient and on the health care system," study author Dr. Lisa Harris, CEO of Eskenazi Health and associate dean of the Indiana University School of Medicine in Indianapolis, said in a press release. "We know, based on our research, that our best opportunity to improve the lives of our patients and, by extension, the health and vitality of our community lies in helping individuals stay well."
All study participants received at least one wraparound service. Dietitian counseling was the most common wraparound service, at 49 percent, followed by consultation with a social worker at 29 percent and behavioral health at 10 percent.
Eskenazi Health includes a 315-bed public hospital and Level I trauma center as well as outpatient services on the main campus and 10 other sites.
It is one of the largest essential healthcare systems in the United States, providing treatment and services to nearly 1 million outpatient visitors each year.
"Given that health and health care use are largely driven by social situations, environmental context and individual behavior, we believe that addressing these issues holds great promise for reducing costs and improving health outcomes," said study author Paul Halverson, founding dean of the Richard M. Fairbanks School of Public Health at IUPUI. "Historically, the healthcare system has not addressed these drivers of health and healthcare costs."