Provision of Social Services and Health Care Quality in US Community Health Centers, 2017

Abstract

Objectives. To describe the types of social services provided at community health centers (CHCs), characteristics of CHCs providing these services, and the association between on-site provision and health care quality.Methods. We surveyed CHCs in 12 US states and the District of Columbia during summer 2017 (n = 208) to identify referral to and provision of services to address 8 social needs. Regression models estimated factors associated with the provision of social services by CHCs and the association between providing services and health care quality (an 8-item composite).Results. CHCs most often offered on-site assistance for needs related to food or nutrition (43%), interpersonal violence (32%), and housing (30%). Participation in projects with community-based organizations was associated with providing services on-site (odds ratio = 2.48; P = .018). On-site provision was associated with better performance on measures of health care quality (e.g., each additional social service was associated with a 4.3 percentage point increase in colorectal cancer screenings).Conclusions. Some CHCs provide social services on-site, and this was associated with better performance on measures of health care quality.Public Health Implications. Health care providers are increasingly seeking to identify and address patients' unmet social needs, and on-site provision of services is 1 strategy to consider.

FIGURE 1—

Percentage of Community Health Centers (CHCs) Offering Each of 8 Social Services by Referral or On-Site: United States, 2017 Note. WIC = Special Supplemental Nutrition Program for Women, Infants, and Children. Respondents were permitted to select both response options (i.e., refer patients to another organization and provide services on-site). Thus, the denominator for each bar is the total number of survey respondents (n = 208). CHCs were more likely to report referring for each service than to report providing each service on-site (for all 8 χ² tests, P < 0.01). Sample includes CHCs in CA, CO, DC, IL, LA, ME, MN, NJ, OR, UT, VT, WA, and WI.

FIGURE 2—

Number of Social Services Provided On-Site or by Referral by Community Health Centers (CHCs): United States, 2017 Note. Results displayed were constructed from a survey question asking respondents to indicate, for each of 8 social services, if services were offered in any of the following ways: (1) “Yes, our staff or another organization provides services on-site”; (2) “Yes, we refer patients to one or more organizations”; (3) “No, we do not provide or refer”; and (4) “No organization is available in our community.” Respondents were instructed to check all that applied. Sample includes CHCs in CA, CO, DC, IL, LA, ME, MN, NJ, OR, UT, VT, WA, and WI.