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Dissertation/Thesis Abstract

Impact of Social Barrier Removal on Primary Care Use by Managed Care Enrollees
by Lyons-Taylor, Pamme A. (“Pamme”), D.H.A., Walden University, 2021, 139; 28314417
Abstract (Summary)

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.

Indexing (document details)
Advisor: Salandy, Simone, Margaritis, Vasileios
Commitee: McDoniel, Scott
School: Walden University
Department: Health Services
School Location: United States -- Minnesota
Source: DAI-B 82/7(E), Dissertation Abstracts International
Subjects: Public health, Health sciences, Health care management
Keywords: Social barrier removal, Primary care, Managed care enrollees
Publication Number: 28314417
ISBN: 9798557099462
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