Social work, cost and health outcomes: A systematic review

Introduction: The continued burden of preventable morbidity and mortality, persistent health inequities, and the implementation of the Affordable Care Act (ACA) are a few of the forces calling the social work (SW) profession to increase its impact in the health justice arena (Ruth et al., 2014).  Although the ACA specifically calls for cost containment and implementation of efficacious interventions that should include social workers; SW has not been named in proposed interventions due to limited data on utility, role, and cost-effectiveness of SW services (Rizzo, 2015). 

Methods: This paper, presents findings from a systematic review of articles published in English between 1994 and 2014in social science and medical databases, applying using search terms of "social work," AND "cost," AND "health.”  Cochrane Intervention Reviews methodological standards were applied.  Articles were included if they (a) evaluated a “social work” or “social service” intervention ; (b) reported physical health outcomes; and (c) referenced an economic evaluation component. 

Results: Of 677 identified articles, only 20 (3%) met inclusion criteria.  Among these, 85% of interventions were led by other disciplines, and 35% of studies did not clearly define the social worker’s role.  Results of these studies indicated that social work involvement in health care is generally cost effective, improving patient-level health outcomes and generating systems-level cost savings. 

Conclusions: As more disciplines become poised to assume traditional social work functions, more research on the economic value of social work interventions is needed.  Studies employing cost-effectiveness, cost-savings, and cost-utility analyses of social work must be prioritized.