Once is rarely enough: can social prescribing facilitate adherence to non-clinical community and voluntary sector health services? Empirical evidence from Germany

BMC Public Health. 2020 Nov 30;20(1):1827. doi: 10.1186/s12889-020-09927-4.


Background: Non-clinical health interventions provided by the voluntary and community sector can improve patients' health and well-being and reduce pressure on primary and secondary care, but only if patients adhere to them. This study provides novel insights into the impact of doctor referrals to such services, known as social prescribing, on patients' adherence to them.

Methods: Using a negative binomial model, we analysed electronic visitor records from a community health advice and navigation service in Germany between January 2018 and December 2019 to determine whether social prescribing was associated with greater adherence to the service (measured in terms of return visits) compared to patients who self-referred. We also explored whether this effect differed according to patient characteristics.

Results: Based on 1734 observations, we found that social prescribing was significantly associated with a greater number of return visits compared to patient self-referrals (p < 0.05). For patients who visited the service because of psychological concerns, the effect of social prescribing was lower. For all other patient characteristics, the effect remained unchanged, suggesting relevance to all other patient groups.

Conclusions: The results of our study indicate that social prescribing may be an effective way to facilitate adherence to non-clinical community and voluntary sector health services. This knowledge is important for policy makers who are deciding whether to implement or expand upon social prescribing schemes.

Keywords: Community and voluntary sector; Deprivation; Germany; Non-clinical health services; Patient engagement; Social prescribing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Community Health Services / statistics & numerical data*
  • Empirical Research
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Referral and Consultation*
  • Social Participation*
  • Voluntary Health Agencies / statistics & numerical data*
  • Young Adult